Contract Pharmacy Details

ACARIAHEALTH PHARMACY #13, INC
CHC266170-07 Via Care Community Health Center, Inc.

Covered Entity Details

Entity Name

Via Care Community Health Center, Inc.

Subdivision Name

Via Care Whittier Dental Clinic

Type

HRSA-Funded Health Center

340B ID

CHC266170-07

Entity Address

5017 Whittier Blvd
Los Angeles, CA 90022-3116

Grant Number

H80CS26617

Participating Start Date

1/1/2020

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

ACARIAHEALTH PHARMACY #13, INC

Pharmacy Address

3302 GARFIELD AVE.
COMMERCE, CA 90040-3102

Pharmacy Comments

Contract Details

Approval Date

10/11/2019

Contract Begin Date

1/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2025
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Nina Falcetti, Director of HR
(323) 268-9191 Ext: 1091

Contract Pharmacy Representative

Acaria Health
Philip Gofman, Regional VP
(917) 312-5263

Signed By Date

10/9/2019

340B Drug Pricing Program Database