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COLUMBUS PHARMACY
CHC28985-10 CENTRAL NEIGHBORHOOD HEALTH FOUNDATION
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Covered Entity Details
Entity Name
CENTRAL NEIGHBORHOOD HEALTH FOUNDATION
Subdivision Name
Central Neighborhood Health Foundation / Carmelitos
Type
HRSA-Funded Health Center
340B ID
CHC28985-10
Entity Address
711 E Via Wanda
Long Beach, CA 90805-6526
Grant Number
H80CS28985
Participating Start Date
4/1/2019
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
COLUMBUS PHARMACY
Pharmacy Address
861 N BROADWAY
LOS ANGELES, CA 90012
Pharmacy Comments
Contract Details
Approval Date
10/16/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/3/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kenneth Orduna, CEO
(323) 547-1402
Contract Pharmacy Representative
Columbus Pharmacy
Liane Chung, Director of Pharmacy
(213) 622-8805
Signed By Date
10/16/2019
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