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PLAZA DRUGS INC.
CH060330 EL CENTRO FAMILY HEALTH
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Covered Entity Details
Entity Name
EL CENTRO FAMILY HEALTH
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH060330
Entity Address
620 CORONADO STREET
ESPANOLA, NM 87532
Grant Number
H80CS00605
Participating Start Date
8/1/1993
Last Recertification Date
3/8/2016
Entity Termination Date
4/1/2016
Pharmacy Details
Pharmacy Name
PLAZA DRUGS INC.
Pharmacy Address
PLAZA DRUGS INC.
178 BRIDGE ST
LAS VEGAS, NM 87701
Pharmacy Comments
Contract Details
Approval Date
9/9/2011
Contract Begin Date
9/9/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2016
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
6/24/2011
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