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LEO'S LAKESIDE PHARMACY
CH093540 NEIGHBORHOOD HEALTHCARE
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Covered Entity Details
Entity Name
NEIGHBORHOOD HEALTHCARE
Subdivision Name
RAY M. DICKINSON WELLNESS CENTER
Type
HRSA-Funded Health Center
340B ID
CH093540
Entity Address
425 N. DATE ST
ESCONDIDO, CA 92025-3413
Grant Number
H80CS00285
Participating Start Date
4/1/1996
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
LEO'S LAKESIDE PHARMACY
Pharmacy Address
ARCHANA CORPORATION DBA
9943 MAINE AVE
LAKESIDE, CA 92040
Pharmacy Comments
Contract Details
Approval Date
12/28/2011
Contract Begin Date
12/28/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/20/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
LISA DAIGLE, CFO
(760) 737-6901
Contract Pharmacy Representative
Raj Zalavdiya, Owner
(619) 443-1013
Signed By Date
11/16/2011
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