Contract Pharmacy Details

COSMED PHARMACY INC.
CHC28368-00 SOUTHERN CALIFORNIA MEDICAL CENTER, INC.

Covered Entity Details

Entity Name

SOUTHERN CALIFORNIA MEDICAL CENTER, INC.

Subdivision Name

Southern California Medical Center (EM)

Type

HRSA-Funded Health Center

340B ID

CHC28368-00

Entity Address

12100 VALLEY BLVD
EL MONTE, CA 91732-3100

Grant Number

H80CS28368

Participating Start Date

10/1/2015

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

COSMED PHARMACY INC.

Pharmacy Address

986 PHARMACY #8006
6521 VAN NUYS BLVD.
VAN NUYS, CA 91401-1425

Pharmacy Comments

Contract Details

Approval Date

4/3/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Abbas Hosseini, System Manager
(818) 421-1035

Contract Pharmacy Representative

COSMED PHARMACY INC.
James Chang, Pharmacist
(626) 319-0686

Signed By Date

4/3/2019

340B Drug Pricing Program Database