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COUNTY OF LOS ANGELES - AUDITOR CONTROLL
CH09316C ARROYO VISTA FAMILY HEALTH FOUNDATION
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Covered Entity Details
Entity Name
ARROYO VISTA FAMILY HEALTH FOUNDATION
Subdivision Name
ARROYO VISTA FAMILY HEALTH CENTER ~ Lincoln Heights
Type
HRSA-Funded Health Center
340B ID
CH09316C
Entity Address
2411 N. BROADWAY
LOS ANGELES, CA 90031-2218
Grant Number
H80CS00374
Participating Start Date
7/1/2004
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
COUNTY OF LOS ANGELES - AUDITOR CONTROLL
Pharmacy Address
313 N FIGUEROA ST STE 1225
HEALTH SERVICES CENTRAL PHARMACY
LOS ANGELES, CA 90012-2602
Pharmacy Comments
Contract Details
Approval Date
1/15/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lorraine J. Estradas, CEO
(323) 254-5291 Ext: 3201
Contract Pharmacy Representative
Olive View UCLA Medical Center
Nadrine Balady-Bouziane, Pharm.D.
(747) 210-3059
Signed By Date
1/15/2016
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