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SAVE MART PHARMACY #608
CH092176B WESTERN SIERRA MEDICAL CLINIC INC
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Covered Entity Details
Entity Name
WESTERN SIERRA MEDICAL CLINIC INC
Subdivision Name
Western Sierra Medical Clinic
Type
HRSA-Funded Health Center
340B ID
CH092176B
Entity Address
844 Old Tunnel Rd
Grass Valley, CA 95945-5952
Grant Number
H80CS08234
Participating Start Date
4/1/2010
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
SAVE MART PHARMACY #608
Pharmacy Address
12054 NEVADA CITY HWY
GRASS VALLEY, CA 95945
Pharmacy Comments
Contract Details
Approval Date
10/16/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Scott McFarland, Chief Executive Officer
(530) 273-4984 Ext: 115
Contract Pharmacy Representative
Robert Vaughn, Senior Director of Pharmacy Operations
(209) 574-6220
Signed By Date
10/16/2013
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