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FP93535 Los Angeles County, Department of Health Services (Terminated)
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Main Details
Name
Los Angeles County, Department of Health Services
Subdivision Name
Lake Los Angeles Clinic
Type
Family Planning (Title X only)
340B ID
FP93535
Grant Number
FPHPA096061
Additional Details
Current Program Status
Terminated
Registration Date
10/2/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/9/2012
Last Recertification Date
5/17/2016
Termination Date
Termination Reason
1/1/2017
Loss of qualifying grant/support
Contacts
Authorizing Official
High Desert Regional Health Center
Beryl Brooks, Administrator
(661) 471-4200
Primary Contact
High Desert Regional Health Center
Romina Panoussi, Chief of Pharmacy
(661) 471-4107
Addresses
Street Address
16921 E. Avenue O, Space G
Lake Los Angeles, CA 93591
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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