Contract Pharmacy Details

DESERT DRUG PHARMACY
FP913844 SAMUEL DIXON FAMILY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

SAMUEL DIXON FAMILY HEALTH CENTER, INC.

Subdivision Name

Type

Family Planning (Title X only)

340B ID

FP913844

Entity Address

30257 SAN MARTINEZ RD
VAL VERDE, CA 91384

Grant Number

FPHPA096061

Participating Start Date

1/1/1998

Last Recertification Date

5/1/2020

Entity Termination Date

7/1/2020

Pharmacy Details

Pharmacy Name

DESERT DRUG PHARMACY

Pharmacy Address

18635 SOLEDAD CANYON ROAD #100
CANYON COUNTRY, CA 91351-3701

Pharmacy Comments

Contract Details

Approval Date

3/5/2012

Contract Begin Date

3/5/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2020
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Cheryl Laymon, Chief Executive Officer
(661) 257-2339 Ext: 301

Contract Pharmacy Representative

Moazzem Chowdhury, R.Ph.
(661) 298-3135

Signed By Date

2/17/2012

340B Drug Pricing Program Database