Contract Pharmacy Details

WESTERN PHARMACY GROUP LLC
CH093030 ADELANTE HEALTHCARE, INC.

Covered Entity Details

Entity Name

ADELANTE HEALTHCARE, INC.

Subdivision Name

Adelante Healthcare

Type

HRSA-Funded Health Center

340B ID

CH093030

Entity Address

3033 N. Central Ave.
Phoenix, AZ 85012-4403

Grant Number

H80CS00140

Participating Start Date

12/1/1992

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

WESTERN PHARMACY GROUP LLC

Pharmacy Address

DBA COMMUNITY MEDICAL CENTER PHARMACY
610 GATEWAY CENTER WAY
SUITES A--E
SAN DIEGO, CA 92102

Pharmacy Comments

Contract Details

Approval Date

4/12/2018

Contract Begin Date

4/16/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/21/2022
Pharmacy closed

Contacts

Covered Entity Signing Official

Eric Battis, COO
(623) 583-3001 Ext: 1222

Contract Pharmacy Representative

Ampla Health
Michelle Darnell, Operations / Business Development Manager
(619) 262-4373

Signed By Date

4/12/2018

340B Drug Pricing Program Database