Contract Pharmacy Details

GARFIELD BEACH CVS, L.L.C.
CHC28984-04 CENTER FOR FAMILY HEALTH & EDUCATION, INC.

Covered Entity Details

Entity Name

CENTER FOR FAMILY HEALTH & EDUCATION, INC.

Subdivision Name

Priority Care Medical Group Mission Hills

Type

HRSA-Funded Health Center

340B ID

CHC28984-04

Entity Address

14901 Rinaldi Street, Suite 202
Mission Hills, CA 91345-1254

Grant Number

H80CS28984

Participating Start Date

7/1/2019

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

GARFIELD BEACH CVS, L.L.C.

Pharmacy Address

CVS PHARMACY # 17123
19105 GOLDEN VALLEY RD
SANTA CLARITA, CA 91387

Pharmacy Comments

Contract Details

Approval Date

7/3/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/18/2019
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Marisol Ramirez, Chief Administrative Officer
(818) 899-5555 Ext: 105

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/3/2019

340B Drug Pricing Program Database