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GARFIELD BEACH CVS, L.L.C.
FQHCLA81C NORTHEAST COMMUNITY CLINIC
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Covered Entity Details
Entity Name
NORTHEAST COMMUNITY CLINIC
Subdivision Name
NECC - GAGE HEALTH CENTER
Type
Health Center Program Look-Alike
340B ID
FQHCLA81C
Entity Address
2975 ZOE AVE
Huntington Park, CA 90255
Grant Number
LALCS00033
Participating Start Date
4/1/2011
Last Recertification Date
2/26/2024
Entity Termination Date
4/1/2024
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09588
15103 HAWTHORNE BOULEVARD
LAWNDALE, CA 90260
Pharmacy Comments
Contract Details
Approval Date
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/1/2023
Pharmacy closed
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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