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FALLBROOK PHARMACY
CH09072E NORTH COUNTY HEALTH PROJECT, INC
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Covered Entity Details
Entity Name
NORTH COUNTY HEALTH PROJECT, INC
Subdivision Name
TrueCare
Type
HRSA-Funded Health Center
340B ID
CH09072E
Entity Address
2210 Mesa Dr Suite 100
Oceanside, CA 92054-3700
Grant Number
H80CS00228
Participating Start Date
1/1/1997
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
FALLBROOK PHARMACY
Pharmacy Address
343 E. ALVARADO ST.
FALLBROOK, CA 92028
Pharmacy Comments
Contract Details
Approval Date
8/23/2012
Contract Begin Date
8/23/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/13/2015
Pharmacy closed
Contacts
Covered Entity Signing Official
Phil Lenowsky, CFO
(760) 736-6760
Contract Pharmacy Representative
Jan Balthasar, CEO
(949) 215-5522
Signed By Date
7/19/2012
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