Contract Pharmacy Details

RALPHS GROCERY CO
CHC11402-10 NORTHEAST COMMUNITY CLINIC, INC

Covered Entity Details

Entity Name

NORTHEAST COMMUNITY CLINIC, INC

Subdivision Name

Northeast Community Clinic - Grand

Type

HRSA-Funded Health Center

340B ID

CHC11402-10

Entity Address

1400 SOUTH GRAND AVENUE STE 700
LOS ANGELES, CA 90015

Grant Number

H80CS12869

Participating Start Date

4/1/2014

Last Recertification Date

2/21/2019

Entity Termination Date

4/1/2020

Pharmacy Details

Pharmacy Name

RALPHS GROCERY CO

Pharmacy Address

DBA RALPHS #132
1770 CARSON ST
TORRANCE, CA 90501

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

10/15/2019
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

CHRISTOPHER LAU, EXECUTIVE DIRECTOR
(626) 457-6900

Contract Pharmacy Representative

Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875

Signed By Date

10/15/2019

340B Drug Pricing Program Database