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ALTAMED PHARMACY 3
CH093110 ALTAMED Health Services Corporation
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Covered Entity Details
Entity Name
ALTAMED Health Services Corporation
Subdivision Name
AltaMed Health Services Corporation Headquarters
Type
HRSA-Funded Health Center
340B ID
CH093110
Entity Address
2040 CAMFIELD AVENUE
Commerce, CA 90040
Grant Number
H80CS00142
Participating Start Date
4/1/2001
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
ALTAMED PHARMACY 3
Pharmacy Address
PHARMEDQUEST PHARMACY SERVICES
5427 WHITTIER BLVD
LOS ANGELES, CA 90022-4101
Pharmacy Comments
Contract Details
Approval Date
7/18/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Castulo De La Rocha, CEO
(323) 725-8751
Contract Pharmacy Representative
AltaMed
Duane Saikami, Pharmacist
(714) 364-1411
Signed By Date
7/18/2014
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