Contract Pharmacy Details

RANCHO PHARMACY
CHC26623-00 OPERATION SAMAHAN, INC.

Covered Entity Details

Entity Name

OPERATION SAMAHAN, INC.

Subdivision Name

OPSAM HEALTH: 2835 Highland

Type

HRSA-Funded Health Center

340B ID

CHC26623-00

Entity Address

2835 Highland Ave
National City, CA 91950-7412

Grant Number

H80CS26623

Participating Start Date

4/1/2014

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

RANCHO PHARMACY

Pharmacy Address

9912 CARMEL MOUNTAIN RD
STE E
SAN DIEGO, CA 92129

Pharmacy Comments

Contract Details

Approval Date

7/18/2017

Contract Begin Date

10/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/26/2018
Pharmacy closed

Contacts

Covered Entity Signing Official

Dirk Darwin Zirbel, CEO
(310) 699-0998

Contract Pharmacy Representative

BP Mukhi Inc
Bhavik Patel, Owner
(760) 592-4650

Signed By Date

7/18/2017