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HOMETOWN PHARMACY
FQHC638017 SANTA YNEZ TRIBAL HEALTH CLINIC
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Covered Entity Details
Entity Name
SANTA YNEZ TRIBAL HEALTH CLINIC
Subdivision Name
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638017
Entity Address
90 VIA JUANA LANE
SANTA YNEZ, CA 93460
Grant Number
Participating Start Date
1/1/1995
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
HOMETOWN PHARMACY
Pharmacy Address
1414 S MILLER STREET
SUITES E & F
SANTA MARIA, CA 93454
Pharmacy Comments
Contract Details
Approval Date
12/2/2010
Contract Begin Date
1/1/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/22/2019
Pharmacy closed
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
11/30/2010
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