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COMPTON COMMUNITY PHARMACY
CH0910370 ST. JOHN'S WELL CHILD AND FAMILY CENTER, INC.
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Covered Entity Details
Entity Name
ST. JOHN'S WELL CHILD AND FAMILY CENTER, INC.
Subdivision Name
St. Johns Well Child and Family Center Magnolia Place
Type
HRSA-Funded Health Center
340B ID
CH0910370
Entity Address
1910 Magnolia Ave
101
Los Angeles, CA 90007
Grant Number
H80CS00873
Participating Start Date
7/1/2003
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
COMPTON COMMUNITY PHARMACY
Pharmacy Address
555 W COMPTON BLVD STE 102
COMPTON, CA 90220-3087
Pharmacy Comments
Contract Details
Approval Date
9/19/2012
Contract Begin Date
9/19/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
James Mangia, CEO
(323) 541-1600 Ext: 4001
Contract Pharmacy Representative
BKNC Pharmacies Inc. DBA Compton Community Pharmacy
Bharat Gandhi, Vice President
(310) 537-2337
Signed By Date
9/4/2012
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