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COUNTY OF LOS ANGELES - AUDITOR CONTROLL
CHC10609-01 UNIVERSITY MUSLIM MEDICAL ASSOCIATION, INC.
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Covered Entity Details
Entity Name
UNIVERSITY MUSLIM MEDICAL ASSOCIATION, INC.
Subdivision Name
Fremont Wellness Center
Type
HRSA-Funded Health Center
340B ID
CHC10609-01
Entity Address
7821 S. Avalon Blvd
Los Angeles, CA 90003-2348
Grant Number
H80CS10609
Participating Start Date
4/1/2015
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
COUNTY OF LOS ANGELES - AUDITOR CONTROLL
Pharmacy Address
313 N FIGUEROA ST STE 1225
HEALTH SERVICES CENTRAL PHARMACY
LOS ANGELES, CA 90012-2602
Pharmacy Comments
Contract Details
Approval Date
7/1/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Adel Syed, CEO
(323) 217-7298
Contract Pharmacy Representative
LA County DHS
Rabeah Elbanna, Pharmacy Supervisor I
(213) 288-7717
Signed By Date
7/1/2019
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