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CIENEGA PHARMACY INC
FP900083 T.H.E. CLINIC INC
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Covered Entity Details
Entity Name
T.H.E. CLINIC INC
Subdivision Name
CLINIC
Type
Family Planning (Title X only)
340B ID
FP900083
Entity Address
3834 SOUTH WESTERN AVENUE
LOS ANGELES, CA 90062
Grant Number
FPHPA006537
Participating Start Date
1/1/1998
Last Recertification Date
5/6/2025
Pharmacy Details
Pharmacy Name
CIENEGA PHARMACY INC
Pharmacy Address
CIENEGA PHARMACY
7360 SANTA MONICA BLVD.
SUITE 101
WEST HOLLYWOOD, CA 90046
Pharmacy Comments
Contract Details
Approval Date
7/2/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Clifford Shiepe, President and CEO
(323) 730-1920 Ext: 3053
Contract Pharmacy Representative
CIENEGA PHARMACY
Afreh Khazaee, President
(310) 360-9969
Signed By Date
7/2/2019
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