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WESTSIDE PHARMACY
CH090880 SANTA CRUZ, COUNTY OF
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Covered Entity Details
Entity Name
SANTA CRUZ, COUNTY OF
Subdivision Name
Homeless Persons' Health Project Coral Street Clinic
Type
HRSA-Funded Health Center
340B ID
CH090880
Entity Address
115A Coral St
Santa Cruz, CA 95060-2104
Grant Number
H80CS00048
Participating Start Date
10/1/1998
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WESTSIDE PHARMACY
Pharmacy Address
1401 MISSION ST
SANTA CRUZ, CA 95060-4738
Pharmacy Comments
Contract Details
Approval Date
4/15/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
CHRISTINE SIPPL, SENIOR HEALTH SERVICES MANAGER
(831) 454-5176
Contract Pharmacy Representative
Chris Quesenberry, Owner
(831) 423-7175
Signed By Date
4/15/2013
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