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AD-RX PHARMACY
CH092440 CLINIC INC, THE
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Covered Entity Details
Entity Name
CLINIC INC, THE
Subdivision Name
T.H.E. CLINIC, INC.
Type
HRSA-Funded Health Center
340B ID
CH092440
Entity Address
3834 S. WESTERN AVE
LOS ANGELES, CA 90062-1104
Grant Number
H80CS00755
Participating Start Date
7/1/2003
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
AD-RX PHARMACY
Pharmacy Address
6240 WILSHIRE BLVD.
LOS ANGELES, CA 90048
Pharmacy Comments
Contract Details
Approval Date
5/11/2012
Contract Begin Date
5/11/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/10/2017
Agreement registered in error
Contacts
Covered Entity Signing Official
RISE PHILLIPS, CHIEF EXECUTIVE OFFICER
(323) 730-1920 Ext: 3007
Contract Pharmacy Representative
Sherri Cherman, President / Chief Operating Officer
(626) 932-1603
Signed By Date
4/20/2012
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