Contract Pharmacy Details

GARFIELD BEACH CVS, L.L.C.
HV90008 T.H.E. CLINIC INC.

Covered Entity Details

Entity Name

T.H.E. CLINIC INC.

Subdivision Name

Type

Ryan White Part C

340B ID

HV90008

Entity Address

3834 S. Western Avenue
Los Angeles, CA 90062

Grant Number

H76HA00734

Participating Start Date

7/1/2003

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

GARFIELD BEACH CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 08892
5822 SOUTH VERMONT AVENUE
LOS ANGELES, CA 90044

Pharmacy Comments

Contract Details

Approval Date

10/3/2019

Contract Begin Date

1/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Clifford Shiepe, President and CEO
(323) 730-1920 Ext: 3053

Contract Pharmacy Representative

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

Signed By Date

10/3/2019

340B Drug Pricing Program Database