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VALLEY PRESCRIPTION AND COMPOUNDING PHAR
FQHCLA338 HORISONS UNLIMITED
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Covered Entity Details
Entity Name
HORISONS UNLIMITED
Subdivision Name
Horisons Unlimited Mariposa
Type
Health Center Program Look-Alike
340B ID
FQHCLA338
Entity Address
5320 STATE HIGHWAY 49 N
MARIPOSA, CA 95338-9588
Grant Number
LALCS00172
Participating Start Date
1/1/2016
Last Recertification Date
1/27/2017
Entity Termination Date
10/12/2017
Pharmacy Details
Pharmacy Name
VALLEY PRESCRIPTION AND COMPOUNDING PHAR
Pharmacy Address
330 E 13TH ST
MERCED, CA 95341-6212
Pharmacy Comments
Contract Details
Approval Date
10/5/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/12/2017
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Sandy Haar, CEO
(209) 201-2099
Contract Pharmacy Representative
Jeff Hill, Owner
(209) 722-5765
Signed By Date
10/5/2016
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