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THE VONS COMPANIES INC
CAH051304-00 JOHN C. FREMONT HEALTHCARE DISTRICT
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Covered Entity Details
Entity Name
JOHN C. FREMONT HEALTHCARE DISTRICT
Subdivision Name
A POLITICAL SUBDIVISION OF THE STATE OF CALIFORNIA
Type
Critical Access Hospital
340B ID
CAH051304-00
Entity Address
5189 HOSPITAL RD
MARIPOSA, CA 95338-0216
Medicare Provider Number
051304
Participating Start Date
1/1/2011
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
THE VONS COMPANIES INC
Pharmacy Address
VONS PHARMACY #2409
40044 HIGHWAY 49
STE D
OAKHURST, CA 93644
Pharmacy Comments
Contract Details
Approval Date
10/15/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ALAN MACPHEE, CHIEF EXECUTIVE OFFICER
(209) 966-3631 Ext: 290
Contract Pharmacy Representative
Safeway
Thuy Le, 340B Program Manager
(925) 467-2825
Signed By Date
10/15/2014
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