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LOS ANGELES COUNTY HEALTH SERVICES CENTRAL PHARMACY
CHC26619-00 KEDREN COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
KEDREN COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Kedren Community Care Clinic
Type
HRSA-Funded Health Center
340B ID
CHC26619-00
Entity Address
4211 Avalon Blvd. Suite A
Los Angeles, CA 90011-5622
Grant Number
H80CS26619
Participating Start Date
7/1/2018
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
LOS ANGELES COUNTY HEALTH SERVICES CENTRAL PHARMACY
Pharmacy Address
313 N FIGUEROA STREET
SUITE 1225
LOS ANGELES, CA 90012
Pharmacy Comments
Contract Details
Approval Date
7/13/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John H. Griffith, Chief Executive Officer
(323) 432-5080 Ext: 151
Contract Pharmacy Representative
DHS
Shane D'Souza, Pharmacy Services Chief II
(213) 240-7717
Signed By Date
7/13/2018
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