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MEDICAL CENTER PHARMACY
CH09312C FAMILY HEALTH CENTERS OF SAN DIEGO, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH CENTERS OF SAN DIEGO, INC.
Subdivision Name
Chula Vista Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH09312C
Entity Address
251 Landis Ave.
Chula Vista, CA 91910-2628
Grant Number
H80CS00224
Participating Start Date
7/1/2009
Last Recertification Date
3/1/2025
Pharmacy Details
Pharmacy Name
MEDICAL CENTER PHARMACY
Pharmacy Address
340 4TH AVENUE
SUITE 1
CHULA VISTA, CA 91910
Pharmacy Comments
Contract Details
Approval Date
9/23/2011
Contract Begin Date
9/26/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/19/2018
Ownership change
Contacts
Covered Entity Signing Official
Fran Butler-Cohen, CEO
(619) 515-2301
Contract Pharmacy Representative
George Awad, Pharmacy Director
(619) 997-4702
Signed By Date
9/7/2011
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