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NEW PHARMACY 2
CHC26610-01 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-YV
Type
HRSA-Funded Health Center
340B ID
CHC26610-01
Entity Address
58375 29 Palms Hwy
Yucca Valley, CA 92284-5813
Grant Number
H80CS26610
Participating Start Date
7/1/2015
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
NEW PHARMACY 2
Pharmacy Address
72724 29 PALMS HWY
STE 104
TWENTYNINE PALMS, CA 92277
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jacqueline Combs, EXECUTIVE DIRECTOR
(760) 820-9229
Contract Pharmacy Representative
New Pharmacy
Maher Michail, Owner
(760) 228-1600
Signed By Date
1/12/2018
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