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MOLLISON 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
MOLLISON PHARMACY
Pharmacy Address
505 N MOLLISON AVE STE 101A
EL CAJON, CA 92021-6159
Pharmacy Comments
Contract Details
Approval Date
1/5/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/7/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
TRACY REAM, CEO
(760) 520-8375
Contract Pharmacy Representative
MERCY CARE PHARMACY
Bassam Massaad, Pharmacist/Owner
(760) 294-0014
Signed By Date
1/5/2017
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