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THE MEDICINE CABINET #5
CHC29048-04 BEHAVIORAL HEALTH SERVICES INC
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Covered Entity Details
Entity Name
BEHAVIORAL HEALTH SERVICES INC
Subdivision Name
BHS - Nuestra Health Center
Type
HRSA-Funded Health Center
340B ID
CHC29048-04
Entity Address
4511 Whittier Blvd
Los Angeles, CA 90022
Grant Number
H80CS29048
Participating Start Date
10/1/2019
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
THE MEDICINE CABINET #5
Pharmacy Address
7037 ATLANTIC AVE
BELL, CA 90201
Pharmacy Comments
Contract Details
Approval Date
10/1/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Ballue, Director Family Health Services
(310) 679-9126
Contract Pharmacy Representative
The Medicine Cabinet
Ash Soliman, Director
(562) 806-8394
Signed By Date
10/1/2019
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