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DOKIMOS' EAST MAIN PHARMACY
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
DOKIMOS' EAST MAIN PHARMACY
Pharmacy Address
640 E MAIN ST STE 2
GRASS VALLEY, CA 95945-5854
Pharmacy Comments
Contract Details
Approval Date
10/1/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Scott McFarland, Chief Executive Officer
(530) 273-4984 Ext: 115
Contract Pharmacy Representative
Signed By Date
10/1/2015
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