340B Drug Pricing Program Database

Name

NORTHEAST COMMUNITY CLINIC, INC

Subdivision Name

Northeast Community Clinic - Huntington Park

Type

Health Center Program Look-Alike

Site ID

BPS-LAL-018003

340B ID

FQHCLA81P

Grant Number

LALCS00033

Current Program Status

Terminated

Registration Date

7/7/2016

Participating Start Date

10/1/2016

Participating Approval Date

7/29/2016

Last Recertification Date

2/9/2018

Termination Date
Termination Reason

4/1/2019
Change of covered entity type (non-hospital)

Authorizing Official

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

Primary Contact

Northeast community Clinic
Oscar Vazquez, Clinic Services Coordinator
(626) 457-5525

Street Address

2822 EAST FLORENCE AVENUE
HUNTINGTON PARK, CA 90255-5749

Billing Address

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