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GAGE PHARMACY
CH098820 CHILDREN'S CLINIC 'SERVING CHILDREN AND THEIR FAMILIES' THE
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Covered Entity Details
Entity Name
CHILDREN'S CLINIC 'SERVING CHILDREN AND THEIR FAMILIES' THE
Subdivision Name
The S. Mark Taper Foundation Children's Clinic Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH098820
Entity Address
455 EAST COLUMBIA ST., STE 201
LONG BEACH, CA 90806-1620
Grant Number
H80CS00264
Participating Start Date
1/1/2000
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
GAGE PHARMACY
Pharmacy Address
AGMMM PHARMACY INC
5735 ATLANTIC AVE
LONG BEACH, CA 90805
Pharmacy Comments
Contract Details
Approval Date
4/16/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/16/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Elisa Nicholas, Chief Executive Officer
(562) 264-3551
Contract Pharmacy Representative
Attef Girgis, Owner
(562) 423-8437
Signed By Date
4/16/2013
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