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MARIN APOTHECARIES, INC.
CH09879W SANTA ROSA COMMUNITY HEALTH CENTERS
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Covered Entity Details
Entity Name
SANTA ROSA COMMUNITY HEALTH CENTERS
Subdivision Name
Van #1 (Tiburcio)
Type
HRSA-Funded Health Center
340B ID
CH09879W
Entity Address
1110 N Dutton Ave
Santa Rosa, CA 95401-4606
Grant Number
H80CS00259
Participating Start Date
7/1/2020
Last Recertification Date
2/3/2022
Entity Termination Date
4/1/2023
Pharmacy Details
Pharmacy Name
MARIN APOTHECARIES, INC.
Pharmacy Address
LOMBARDI ROSA PHARMACY
751 LOMBARDI CT
SUITE 100
SANTA ROSA, CA 95407-6798
Pharmacy Comments
Contract Details
Approval Date
12/18/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Naomi Fuchs, CEO
(707) 303-3600 Ext: 3111
Contract Pharmacy Representative
Santa Rose Community Health Centers
Brittany Norton, Regional Pharmacy Manager- West
(707) 596-0174
Signed By Date
12/18/2017
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