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MISSION WELLNESS PHARMACY
CH09107U SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM
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Covered Entity Details
Entity Name
SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM
Subdivision Name
HealthRIGHT360
Type
HRSA-Funded Health Center
340B ID
CH09107U
Entity Address
558 Clayton St
San Francisco, CA 94117-2907
Grant Number
H80CS00049
Participating Start Date
7/1/1998
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
MISSION WELLNESS PHARMACY
Pharmacy Address
2424 MISSION STREET
SAN FRANCISCO, CA 94110
Pharmacy Comments
Contract Details
Approval Date
10/5/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Vitka Eisen, CEO
(415) 762-1558
Contract Pharmacy Representative
Maria Lopez, Pharmacist in Charge/Manager
(415) 826-3484
Signed By Date
10/5/2015
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