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MDM PHARMACY SERVICES LLC - DBA NEW PHAR
CHC26610-00 HI-DESERT MEMORIAL HEALTH CARE DISTRICT
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Covered Entity Details
Entity Name
HI-DESERT MEMORIAL HEALTH CARE DISTRICT
Subdivision Name
Morongo Basin Community Health Center-SR
Type
HRSA-Funded Health Center
340B ID
CHC26610-00
Entity Address
6380 Split Rock Ave
Twentynine Palms, CA 92277
Grant Number
H80CS26610
Participating Start Date
7/1/2015
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
MDM PHARMACY SERVICES LLC - DBA NEW PHAR
Pharmacy Address
NEW PHARMACY
57725 29 PALMS HWY
STE 209
YUCCA VALLEY, CA 92284
Pharmacy Comments
Contract Details
Approval Date
6/11/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
NORA MAUGHAN, EXECUTIVE DIRECTOR
(760) 366-6120
Contract Pharmacy Representative
New Pharmacy
Maher Michail, Owner
(760) 228-1600
Signed By Date
6/11/2015
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