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LINDA VISTA PHARMACY
CH0911100 SAN DIEGO FAMILY CARE
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Covered Entity Details
Entity Name
SAN DIEGO FAMILY CARE
Subdivision Name
LINDA VISTA HEALTH CARE CENTER
Type
HRSA-Funded Health Center
340B ID
CH0911100
Entity Address
6973 Linda Vista Rd
San Diego, CA 92111-6342
Grant Number
H80CS02319
Participating Start Date
4/1/1996
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
LINDA VISTA PHARMACY
Pharmacy Address
2361 ULRIC ST
SAN DIEGO, CA 92111
Pharmacy Comments
Contract Details
Approval Date
7/9/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ROBERTA L. FEINBERG, CHIEF EXECUTIVE OFFICER
(858) 279-9676
Contract Pharmacy Representative
Tien Bui, RPh/Owner
(585) 277-6147
Signed By Date
7/9/2013
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