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CH09100Y NORTHEAST VALLEY HEALTH CORPORATION (Active)
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Main Details
Name
NORTHEAST VALLEY HEALTH CORPORATION
Subdivision Name
PEDIATRIC HEALTH & WIC CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005014
340B ID
CH09100Y
Grant Number
H80CS00139
Additional Details
Current Program Status
Active
Registration Date
5/22/2007
Participating Start Date
7/1/2007
Participating Approval Date
5/23/2007
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Northeast Valley Health Corporation
Kimberly Wyard, Chief Executive Officer
(818) 898-1388 Ext: 41620
Primary Contact
Northeast Valley Health Corporation
Artashes R Khachatryan, Pharmacy Director/Primary Contact
(818) 365-8086 Ext: 50205
Addresses
Street Address
7138 Van Nuys Blvd
Van Nuys, CA 91405-3005
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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