340B Drug Pricing Program Database
E.V.A HEALTH LLC
FQHCLA298 Centro Medico Community Clinic, Inc. - information as of 5/30/2025 8:41:22 PM
Covered Entity Details
Entity Name
Centro Medico Community Clinic, Inc.
Subdivision Name
Type
Health Center Program Look-Alike
340B ID
FQHCLA298
Entity Address
1303 W 6th St
105
Corona, CA 92882
Grant Number
LALCS00062
Participating Start Date
7/1/2012
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
E.V.A HEALTH LLC
Pharmacy Address
DBA: CITRUS VALLEY PHARMACY
15869 AMAR RD
LA PUENTE, CA 91744
Pharmacy Comments
Contract Details
Approval Date
10/3/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Andy Piskoulian, CEO
(951) 278-8910
Contract Pharmacy Representative
Citrus Valley Pharmacy
Chad Nour, CEO
(626) 261-4400
Signed By Date
10/3/2019
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