Contract Pharmacy Details

AG PHARMACY
CH09107A SF COMMUNITY CLINIC CONSORTIUM

Covered Entity Details

Entity Name

SF COMMUNITY CLINIC CONSORTIUM

Subdivision Name

TOM WADDELL HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH09107A

Entity Address

50 Dr Tom Waddell Pl
SAN FRANCISCO, CA 94102

Grant Number

H80CS00049

Participating Start Date

7/1/1997

Last Recertification Date

1/31/2023

Entity Termination Date

4/1/2023

Pharmacy Details

Pharmacy Name

AG PHARMACY

Pharmacy Address

3636 CESAR CHAVEZ
SAN FRANCISCO, CA 94110

Pharmacy Comments

Contract Details

Approval Date

3/1/2013

Contract Begin Date

4/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/4/2016
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Susan Currin, Chief Executive Officer
(415) 206-3517

Contract Pharmacy Representative

Vivian Cheung, Pharmacy Manager
(415) 657-3757

Signed By Date

1/10/2013

340B Drug Pricing Program Database