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QUALICARE PHARMACY SERVICES
FP900083 T.H.E. CLINIC INC
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Covered Entity Details
Entity Name
T.H.E. CLINIC INC
Subdivision Name
CLINIC
Type
Family Planning (Title X only)
340B ID
FP900083
Entity Address
3834 SOUTH WESTERN AVENUE
LOS ANGELES, CA 90062
Grant Number
FPHPA006537
Participating Start Date
1/1/1998
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
QUALICARE PHARMACY SERVICES
Pharmacy Address
3779-3779 1/2 S WESTERN AVE
LOS ANGELES, CA 90018
Pharmacy Comments
Contract Details
Approval Date
10/3/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Clifford Shiepe, President and CEO
(323) 730-1920 Ext: 3053
Contract Pharmacy Representative
QUALICARE PHARMACY SERVICES
Jahan Shams, Pharmacist
(323) 731-4004
Signed By Date
10/3/2018
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