Contract Pharmacy Details

RX E-FILL SOLUTIONS
CHC08241-26 Mission City Community Network, Inc.

Covered Entity Details

Entity Name

Mission City Community Network, Inc.

Subdivision Name

Mission City Community Network- Hollywood-Santa Monica

Type

HRSA-Funded Health Center

340B ID

CHC08241-26

Entity Address

5300 Santa Monica Blvd Suite 202
Los Angeles, CA 90029-1258

Grant Number

H80CS08241

Participating Start Date

4/1/2019

Last Recertification Date

1/30/2023

Entity Termination Date

4/1/2024

Pharmacy Details

Pharmacy Name

RX E-FILL SOLUTIONS

Pharmacy Address

CARDINAL HEALTH PHARMACY SERVICES, LLC
27680 AVENUE MENTRY STE 100
VALENCIA, CA 91355

Pharmacy Comments

Contract Details

Approval Date

4/2/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Nik Gupta, CEO
(818) 895-3100

Contract Pharmacy Representative

Cardinal Health Pharmacy
Robert Kulis, SVP GM Pharmacy Solutions
(281) 749-4083

Signed By Date

4/2/2019

340B Drug Pricing Program Database