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GRUBB'S PHARMACY SE, INC.
CH036820 LA CLINICA DEL PUEBLO
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Covered Entity Details
Entity Name
LA CLINICA DEL PUEBLO
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH036820
Entity Address
2831 15TH STREET NW
WASHINGTON, DC 20009
Grant Number
H80CS08244
Participating Start Date
1/1/2008
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
GRUBB'S PHARMACY SE, INC.
Pharmacy Address
GRUBBS PHARMACY SE, INC.
1800 MARTIN LUTHER KING JR AVE SE
WASHINGTON, DC 20020-6900
Pharmacy Comments
Contract Details
Approval Date
7/12/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Catalina Sol, Executive Director
(202) 448-2810
Contract Pharmacy Representative
Grubb's
michael kim, president
(202) 387-2435
Signed By Date
7/12/2019
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