Contract Pharmacy Details

HORSNYDER PHARMACY
CH09116B SALUD PARA LA GENTE

Covered Entity Details

Entity Name

SALUD PARA LA GENTE

Subdivision Name

BEACH FLATS HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH09116B

Entity Address

302 Riverside Ave
Santa Cruz, CA 95060-5524

Grant Number

H80CS00226

Participating Start Date

7/1/2012

Last Recertification Date

3/7/2016

Entity Termination Date

4/1/2017

Pharmacy Details

Pharmacy Name

HORSNYDER PHARMACY

Pharmacy Address

1226-A SOQUEL AVE
SANTA CRUZ, CA 95062

Pharmacy Comments

Contract Details

Approval Date

3/14/2013

Contract Begin Date

4/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/12/2015
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Zettie D. Page, CEO
(831) 728-8250

Contract Pharmacy Representative

Mark Wilson, Pharmacist in Charge
(831) 423-2315

Signed By Date

1/14/2013