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HILLCREST PHARMACY
RWI921010 Christie's Place, Inc.
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Covered Entity Details
Entity Name
Christie's Place, Inc.
Subdivision Name
Type
Ryan White Part A
340B ID
RWI921010
Entity Address
2440 Third Avenue
San Diego, CA 92101
Grant Number
H89HA00001
Participating Start Date
4/1/2020
Last Recertification Date
Entity Termination Date
4/1/2021
Pharmacy Details
Pharmacy Name
HILLCREST PHARMACY
Pharmacy Address
120 UNIVERSITY AVE
SAN DIEGO, CA 92103
Pharmacy Comments
Contract Details
Approval Date
4/17/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Erin Falvey, Executive Director
(619) 702-4186
Contract Pharmacy Representative
Hillcrest Pharmacy
Susan Baeza, Owner
(619) 260-1010
Signed By Date
4/17/2017
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