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AG PHARMACY
CH09107BR San Francisco Community Clinic Consortium
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Covered Entity Details
Entity Name
San Francisco Community Clinic Consortium
Subdivision Name
Tom Waddell Urban Health Clinic
Type
HRSA-Funded Health Center
340B ID
CH09107BR
Entity Address
220 Golden Gate Avenue
San Francisco, CA 94102-3706
Grant Number
H80CS00049
Participating Start Date
4/1/2013
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
AG PHARMACY
Pharmacy Address
3636 CESAR CHAVEZ
SAN FRANCISCO, CA 94110
Pharmacy Comments
Contract Details
Approval Date
4/9/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2018
Pharmacy closed
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
4/9/2013
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