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ATLANTIC PHARMACY
CHC266170-05 Via Care Community Health Center, Inc.
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Covered Entity Details
Entity Name
Via Care Community Health Center, Inc.
Subdivision Name
Via Care Chronic Disease Care Clinic
Type
HRSA-Funded Health Center
340B ID
CHC266170-05
Entity Address
615 S Atlantic Blvd
Los Angeles, CA 90022-3211
Grant Number
H80CS26617
Participating Start Date
4/1/2019
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
ATLANTIC PHARMACY
Pharmacy Address
5119 E. BEVERLY BLVD.
LOS ANGELES, CA 90022-1734
Pharmacy Comments
Contract Details
Approval Date
1/10/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nina Falcetti, Director of HR
(323) 268-9191 Ext: 1091
Contract Pharmacy Representative
Atlantic Pharmacy
Chi Cheng, Pharmacist
(323) 264-5060
Signed By Date
1/10/2020
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