Contract Pharmacy Details

CRENSHAW PHARMACY INC
CH09244C Clinic Inc, The

Covered Entity Details

Entity Name

Clinic Inc, The

Subdivision Name

T.H.E. Clinic at Hawthorne

Type

HRSA-Funded Health Center

340B ID

CH09244C

Entity Address

10321 HAWTHORNE BLVD
INGLEWOOD, CA 90304-1500

Grant Number

H80CS00755

Participating Start Date

4/1/2018

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

CRENSHAW PHARMACY INC

Pharmacy Address

DBA CRENSHAW PHARMACY
3631 CRENSHAW BLVD #111
LOS ANGELES, CA 90016

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

Crenshaw Pharmacy
KOHANCHI NASTARAN ESTHER, PHARMACIST
(323) 732-5555

Signed By Date

10/3/2018

340B Drug Pricing Program Database