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KOVACS FREY PHARMACY
CH0910260 SOUTH BAY FAMILY HEALTH CARE CENTER INC
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Covered Entity Details
Entity Name
SOUTH BAY FAMILY HEALTH CARE CENTER INC
Subdivision Name
SOUTH BAY FAMILY HEALTHCARE CENTER
Type
HRSA-Funded Health Center
340B ID
CH0910260
Entity Address
23430 Hawthorne Blvd
Torrance, CA 90505-4720
Grant Number
H80CS00877
Participating Start Date
4/1/2004
Last Recertification Date
2/4/2021
Entity Termination Date
1/1/2022
Pharmacy Details
Pharmacy Name
KOVACS FREY PHARMACY
Pharmacy Address
2860 ARTESIA BLVD
REDONDO BEACH, CA 90278
Pharmacy Comments
Contract Details
Approval Date
7/5/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/20/2015
Ownership change
Contacts
Covered Entity Signing Official
JANN HAMILTON LEE, CHIEF EXECUTIVE OFFICER
(310) 802-6177 Ext: 1105
Contract Pharmacy Representative
Odette Leonelli, Pharmacist Owner
(310) 371-7541
Signed By Date
7/5/2013
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