Contract Pharmacy Details

AMC COMMUNITY PHARMACY
CH092080 ALLIANCE MEDICAL CENTER, INC.

Covered Entity Details

Entity Name

ALLIANCE MEDICAL CENTER, INC.

Subdivision Name

ALLIANCE MEDICAL CENTER

Type

HRSA-Funded Health Center

340B ID

CH092080

Entity Address

1381 UNIVERSITY AVENUE
HEALDSBURG, CA 95448-3314

Grant Number

H80CS00249

Participating Start Date

4/1/1996

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

AMC COMMUNITY PHARMACY

Pharmacy Address

1381 UNIVERSITY ST SUITE A
HEALDSBURG, CA 95448

Pharmacy Comments

Contract Details

Approval Date

3/22/2016

Contract Begin Date

4/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/14/2019
Ownership change

Contacts

Covered Entity Signing Official

Alex Armstrong, CEO
(707) 385-2306

Contract Pharmacy Representative

imgRx
Cristie Pellegrini, National Pharmacy Director
(512) 596-2930 Ext: 706

Signed By Date

3/22/2016

340B Drug Pricing Program Database