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CH092143Y Los Angeles Christian Health Centers (Terminated)
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Main Details
Name
Los Angeles Christian Health Centers
Subdivision Name
Los Angeles Christian Health Centers at Grape Street Elementary
Type
HRSA-Funded Health Center
Site ID
BPS-H80-018112
340B ID
CH092143Y
Grant Number
H80CS06674
Additional Details
Current Program Status
Terminated
Registration Date
4/11/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/19/2017
Last Recertification Date
2/15/2019
Termination Date
Termination Reason
4/1/2020
Site closure
Contacts
Authorizing Official
Los Angeles Christian Health Centers
Bettina Lewis, Chief Operations Officer
(213) 893-1960
Primary Contact
Los Angeles Christian Health Centers
Elaine Rivera, Pharmacy Director
(323) 268-8391
Addresses
Street Address
1940 E. 111th Street
Los Angeles, CA 90059
Billing Address
Los Angeles Christian Health Centers
202 W 1st
Suite #4-0435
Los Angeles, CA 90012
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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