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DEMARTINI SPRING HILL PHCY INC
CH0921760 WESTERN SIERRA MEDICAL CLINIC
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Covered Entity Details
Entity Name
WESTERN SIERRA MEDICAL CLINIC
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH0921760
Entity Address
209 NEVADA STREET
DOWNIEVILLE, CA 95936
Grant Number
H80CS08234
Participating Start Date
4/1/2007
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
DEMARTINI SPRING HILL PHCY INC
Pharmacy Address
DEMARTINI'S COMPOUNDING CENTER
102 CATHERINE LANE
GRASS VALLEY, CA 95945-9594
Pharmacy Comments
Contract Details
Approval Date
10/16/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/31/2016
Pharmacy closed
Contacts
Covered Entity Signing Official
Scott McFarland, Chief Executive Officer
(530) 273-4984 Ext: 115
Contract Pharmacy Representative
DAVID DEMARTINI, PRESIDENT
(530) 273-2268
Signed By Date
10/16/2013
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