Covered Entity Details

FQHCLA81C NORTHEAST COMMUNITY CLINIC (Terminated)

Main Details

Name

NORTHEAST COMMUNITY CLINIC

Subdivision Name

NECC - GAGE HEALTH CENTER

Type

Health Center Program Look-Alike

Site ID

BPS-LAL-012825

340B ID

FQHCLA81C

Grant Number

LALCS00033

Additional Details

Current Program Status

Terminated

Registration Date

5/31/2007

Participating Start Date

4/1/2011

Participating Approval Date

3/31/2011

Last Recertification Date

2/26/2024

Termination Date
Termination Reason

4/1/2024
Change of covered entity type (non-hospital)

Contacts

Authorizing Official

Northeast Community Clinic
CHRISTOPHER LAU, EXECUTIVE DIRECTOR
(626) 457-6900

Primary Contact

Northeast Community Clinic
Emely Orozco, Pharmacy Program Administrator
(626) 457-5209

Addresses

Street Address

2975 ZOE AVE
Huntington Park, CA 90255

Billing Address

NORTHEAST COMMUNITY CLINIC
2550 W MAIN STREET, SUITE 301
ALHAMBRA, CA 91801

Comment	Last Updated On
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12/30/13 updated site ID to match address change approved in July by J. Hardin; 13/31/11 PARTICIPATING 7/1/07-12/31/09, PARTICIPATION TERMINATED (IN ERROR) 1/1/10-3/31/11; 6/9/2008- UPDATED CITY (HUNTINGTON PARK)	12/30/2013
3/31/11 PARTICIPATING 7/1/07-12/31/09, PARTICIPATION TERMINATED (IN ERROR) 1/1/10-3/31/11; 6/9/2008- UPDATED CITY (HUNTINGTON PARK)	05/31/2007

340B Drug Pricing Program Database