Contract Pharmacy Details

VHC @ MILPITAS PHARMACY
FQHCLA263B MAYVIEW COMMUNITY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

MAYVIEW COMMUNITY HEALTH CENTER, INC.

Subdivision Name

MAYVIEW COMMUNITY HEALTH CENTER - CNC

Type

Health Center Program Look-Alike

340B ID

FQHCLA263B

Entity Address

785 MORSE AVENUE
SUNNYVALE, CA 94085-3010

Grant Number

LALCS00001

Participating Start Date

7/1/2010

Last Recertification Date

1/27/2020

Entity Termination Date

7/1/2020

Pharmacy Details

Pharmacy Name

VHC @ MILPITAS PHARMACY

Pharmacy Address

143 N MAIN ST
SUITE 1038
MILPITAS, CA 95035-4322

Pharmacy Comments

12/04/2012 pharmacy update (was Valley Health Center at Silvercreek Pharmacy 1620 East Capitol Expressway San Jose 95121)

Contract Details

Approval Date

2/14/2013

Contract Begin Date

4/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2020
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Shamima Hasan, CEO
(650) 327-1223

Contract Pharmacy Representative

SCVMC
Narinder Singh, Director of Pharmacy
(408) 885-2300

Signed By Date

1/11/2013

340B Drug Pricing Program Database