Contract Pharmacy Details

ENBORG LANE PHARMACY
CH091181N SANTA CLARA, COUNTY OF

Covered Entity Details

Entity Name

SANTA CLARA, COUNTY OF

Subdivision Name

Medical Mobile Unit Teen Van #2

Type

HRSA-Funded Health Center

340B ID

CH091181N

Entity Address

660 S. Fair Oaks Ave FL 1 and 2
Sunnyvale, CA 94086-7913

Grant Number

H80CS01442

Participating Start Date

1/1/2014

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

ENBORG LANE PHARMACY

Pharmacy Address

2221 ENBORG LANE
1J018
SAN JOSE, CA 95128

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

340B Drug Pricing Program Database