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LOS ANGELES COUNTY HEALTH SERVICES CENTRAL PHARMACY
FQHCLA81B NORTHEAST COMMUNITY CLINIC, INC
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Covered Entity Details
Entity Name
NORTHEAST COMMUNITY CLINIC, INC
Subdivision Name
Northeast Community Clinic - Community Medical Alliance
Type
Health Center Program Look-Alike
340B ID
FQHCLA81B
Entity Address
4129 E Gage Ave
Bell, CA 90201
Grant Number
LALCS00033
Participating Start Date
4/1/2011
Last Recertification Date
3/4/2025
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
4/10/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/31/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
CHRISTOPHER LAU, EXECUTIVE DIRECTOR
(626) 457-6900
Contract Pharmacy Representative
LA County DHS
Rabeah Elbanna, Pharmacy Supervisor I
(213) 288-7717
Signed By Date
4/10/2015
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