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SANTA CLARA VALLEY MEDICAL
CH091181Q SANTA CLARA, COUNTY OF
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Covered Entity Details
Entity Name
SANTA CLARA, COUNTY OF
Subdivision Name
Medical Mobile Unit #1
Type
HRSA-Funded Health Center
340B ID
CH091181Q
Entity Address
2101 Alexian Avenue STE D
San Jose, CA 95116
Grant Number
H80CS01442
Participating Start Date
1/1/2014
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
SANTA CLARA VALLEY MEDICAL
Pharmacy Address
CENTER OUTPATIENT PHARMACY
751 S BASCOM AVE STE 150
SAN JOSE, CA 95128-2604
Pharmacy Comments
Contract Details
Approval Date
1/23/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/6/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
DAVID CLAUDE, CHIEF FINANCIAL OFFICER
(408) 793-6540
Contract Pharmacy Representative
SCVMC
Narinder Singh, Director of Pharmacy
(408) 885-2300
Signed By Date
1/23/2014
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