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WAL-MART PHARMACY 10-2886
CHC12858-01 FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, INC.
Subdivision Name
Hawaiian Gardens Health Center
Type
HRSA-Funded Health Center
340B ID
CHC12858-01
Entity Address
22310 Wardham Ave
Hawaiian Gardens, CA 90716-1740
Grant Number
H80CS12858
Participating Start Date
1/1/2015
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2886
Pharmacy Address
8500 WASHINGTON BLVD.
PICO RIVERA, CA 90660
Pharmacy Comments
Contract Details
Approval Date
7/1/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Raquel R. Villa, Chief Executive Officer
(562) 776-5014
Contract Pharmacy Representative
Family Health Care Centers of Greater Los Angeles, INC.
Cindy C Wong, Pharmacist
(562) 776-5050
Signed By Date
7/1/2020
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