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RALPHS GROCERY CO
CHC26620-00 KOREAN HEALTH, EDUCATION, INFORMATION AND RESEARCH CENTER
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Covered Entity Details
Entity Name
KOREAN HEALTH, EDUCATION, INFORMATION AND RESEARCH CENTER
Subdivision Name
Kheir Clinic
Type
HRSA-Funded Health Center
340B ID
CHC26620-00
Entity Address
3727 West 6th Street
200
Los Angeles, CA 90020-5108
Grant Number
H80CS26620
Participating Start Date
7/1/2014
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
RALPHS GROCERY CO
Pharmacy Address
DBA RALPHS #289
5601 WILSHIRE BLVD
LOS ANGELES, CA 90036
Pharmacy Comments
Contract Details
Approval Date
7/9/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/4/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Erin Pak, CEO
(213) 427-4000 Ext: 107
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
7/9/2020
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