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ALLIED HEALTH PARTNER INC
FQHCLA321 Southern California Medical Center
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Covered Entity Details
Entity Name
Southern California Medical Center
Subdivision Name
Southern California Medical Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA321
Entity Address
8825 Whittier Blvd.
Pico Rivera, CA 90660-2600
Grant Number
LALCS00144
Participating Start Date
1/1/2014
Last Recertification Date
2/11/2019
Entity Termination Date
7/1/2019
Pharmacy Details
Pharmacy Name
ALLIED HEALTH PARTNER INC
Pharmacy Address
DBA ALLIED HEALTH PHARMACY
14659 VICTORY BLVD
VAN NUYS, CA 91411
Pharmacy Comments
Contract Details
Approval Date
10/11/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Abbas Hosseini, System Manager
(818) 421-1035
Contract Pharmacy Representative
allied health pharmacy
Ken Jalali, CEO
(818) 357-4015
Signed By Date
10/11/2018
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