340B Drug Pricing Program Database

Name

NORTHEAST COMMUNITY CLINIC, INC

Subdivision Name

Northeast Community Clinic - Elizabeth Health Center

Type

Health Center Program Look-Alike

Site ID

BPS-LAL-011432

340B ID

FQHCLA81L

Grant Number

LALCS00033

Current Program Status

Terminated

Registration Date

4/12/2013

Participating Start Date

7/1/2013

Participating Approval Date

5/20/2013

Last Recertification Date

3/9/2016

Termination Date
Termination Reason

4/1/2017
Site closure

Authorizing Official

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

Primary Contact

Northeast Community Clinic
Bernardo Carrillo, OPERATIONS DIRECTOR
(626) 457-6900

Street Address

2822 EAST FLORENCE AVENUE
HUNTINGTON PARK, CA 90255-5749

Billing Address

Northeast Community Clinic
2550 W. Main St. #301
Alhambra, CA 91801