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SANTA CLARA COUNTY PUBLIC
FQHCLA263B MAYVIEW COMMUNITY HEALTH CENTER, INC.
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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
SANTA CLARA COUNTY PUBLIC
Pharmacy Address
VHC AT LENZEN PHARMACY
976 LENZEN AVENUE
SAN JOSE, CA 95126
Pharmacy Comments
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
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