340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SISKIYOU PHARMACY SERVICES
FQHC638008 KARUK TRIBE
Print
Covered Entity Details
Entity Name
KARUK TRIBE
Subdivision Name
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638008
Entity Address
64109 Hill side Road
HAPPY CAMP, CA 96039
Grant Number
Participating Start Date
1/1/1995
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
SISKIYOU PHARMACY SERVICES
Pharmacy Address
DBA MEDICAL CENTER PHARMACY
742 S. MAIN STREET
YREKA, CA 96097
Pharmacy Comments
Contract Details
Approval Date
7/10/2012
Contract Begin Date
7/10/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/30/2018
Pharmacy closed
Contacts
Covered Entity Signing Official
Lessie Aubrey, Manager of Grants, Compliance
(530) 493-1600 Ext: 2042
Contract Pharmacy Representative
Candice Amens, Owner
(530) 842-4301
Signed By Date
6/25/2012
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session