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CHC11402-16 NORTHEAST COMMUNITY CLINIC, INC (Active)
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Main Details
Name
NORTHEAST COMMUNITY CLINIC, INC
Subdivision Name
Northeast Community Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027706
340B ID
CHC11402-16
Grant Number
H80CS12869
Additional Details
Current Program Status
Active
Registration Date
7/3/2019
Participating Start Date
10/1/2019
Participating Approval Date
8/29/2019
Last Recertification Date
3/4/2025
Contacts
Authorizing Official
Northeast Community Clinic
CHRISTOPHER LAU, EXECUTIVE DIRECTOR
(626) 457-6900
Primary Contact
Northeast Community Clinic
Emely Orozco, Pharmacy Program Administrator
(626) 457-5209
Addresses
Street Address
1414 S Grand Ave Ste 200
Los Angeles, CA 90015-3072
Billing Address
Northeast Community Clinic
2550 West Main St.
301
Alhambra, CA 91801
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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