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VHC @ MILPITAS PHARMACY
FQHCLA263A 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 - MV
Type
Health Center Program Look-Alike
340B ID
FQHCLA263A
Entity Address
900 MIRAMONTE AVENUE
2ND FLOOR
MOUNTAIN VIEW, CA 94040-2457
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
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