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CLINIC PHARMACIES III, 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
CLINIC PHARMACIES III, INC
Pharmacy Address
DBA WESTERN SIERRA PHARMACY
844 OLD TUNNEL RD
GRASS VALLEY, CA 95945
Pharmacy Comments
Contract Details
Approval Date
4/13/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/15/2019
Ownership change
Contacts
Covered Entity Signing Official
Scott McFarland, Chief Executive Officer
(530) 273-4984 Ext: 115
Contract Pharmacy Representative
Cardinal Health
Naveen Mansukhani, National Operations Director
(732) 328-0515
Signed By Date
4/13/2017
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