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GARFIELD BEACH CVS, L.L.C.
CHC11402-09 NORTHEAST COMMUNITY CLINIC, INC
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Covered Entity Details
Entity Name
NORTHEAST COMMUNITY CLINIC, INC
Subdivision Name
Wilmington Family Health Center
Type
HRSA-Funded Health Center
340B ID
CHC11402-09
Entity Address
200 E Anaheim St
Wilmington, CA 90744-4516
Grant Number
H80CS12869
Participating Start Date
1/1/2010
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
CVS/PHARMACY #10292
4030 SOUTH WESTERN AVE.
LOS ANGELES, CA 90062
Pharmacy Comments
Contract Details
Approval Date
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
CHRISTOPHER LAU, EXECUTIVE DIRECTOR
(626) 457-6900
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2019
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