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SANTA MARIA PHARMACY
CHC10608-00 CENTRAL CITY COMMUNITY HEALTH CENTER, INC
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Covered Entity Details
Entity Name
CENTRAL CITY COMMUNITY HEALTH CENTER, INC
Subdivision Name
Central City Community Health Center, Inc. - Anaheim
Type
HRSA-Funded Health Center
340B ID
CHC10608-00
Entity Address
2237 W.Ball Road
Anaheim, CA 92804-5314
Grant Number
H80CS10608
Participating Start Date
7/1/2024
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
SANTA MARIA PHARMACY
Pharmacy Address
SANTA MARIA PHARMACY INC
2288 S GAREY AVE
POMONA, CA 91766-5645
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/26/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Gerardo Ramirez, Controller
(323) 694-2715
Contract Pharmacy Representative
Santa Maria Pharmacy
Marcos Soleman, Owner
(626) 443-3089
Signed By Date
10/15/2019
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