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CH092134J Eisner Health at Panorama City OB (Terminated)
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Main Details
Name
Eisner Health at Panorama City OB
Subdivision Name
Eisner Health at Panorama City OB
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017444
340B ID
CH092134J
Grant Number
H80CS04223
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/10/2016
Last Recertification Date
2/9/2023
Termination Date
Termination Reason
4/1/2024
Site closure
Contacts
Authorizing Official
Eisner Health
Warren J Brodine, Chief Executive Officer
(213) 746-1037 Ext: 3305
Primary Contact
Eisner Health
Nicole Marie Tavares-Kuhn, Director, Pharmacy Services
(213) 588-0467
Addresses
Street Address
15251 Roscoe Blvd
Panorama City, CA 91402
Billing Address
Eisner Health
1530 S Olive St
Los Angeles, CA 90015
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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