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LOS ANGELES COUNTY HEALTH SERVICES CENTRAL 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
LOS ANGELES COUNTY HEALTH SERVICES CENTRAL PHARMACY
Pharmacy Address
313 N FIGUEROA STREET
SUITE 1225
LOS ANGELES, CA 90012
Pharmacy Comments
Contract Details
Approval Date
4/2/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/15/2015
Agreement registered in error
Contacts
Covered Entity Signing Official
JANN HAMILTON LEE, CHIEF EXECUTIVE OFFICER
(310) 802-6177 Ext: 1105
Contract Pharmacy Representative
Yana Polsen, Supervisor
(213) 406-2758
Signed By Date
4/2/2015
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