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PALM PHARMACY
CH09365A CLINICAS DEL CAMINO REAL, INC.
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Covered Entity Details
Entity Name
CLINICAS DEL CAMINO REAL, INC.
Subdivision Name
Clinicas Del Camino Real Inc - Fillmore
Type
HRSA-Funded Health Center
340B ID
CH09365A
Entity Address
355 Central Ave
Fillmore, CA 93015-1920
Grant Number
H80CS00550
Participating Start Date
7/1/1995
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
PALM PHARMACY
Pharmacy Address
254 E HARVARD BLVD.
SANTA PAULA, CA 93060-3372
Pharmacy Comments
Contract Details
Approval Date
7/13/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/12/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
ANIL CHAWLA, CMO/MEDICAL DIRECTOR
(805) 659-1740
Contract Pharmacy Representative
Independent
Sanjiv Pandya, Owner
(805) 525-8700
Signed By Date
7/13/2013
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