Contract Pharmacy Details

MORNINGSIDE MEDICAL PHARMACY INC
CH091037D ST. JOHN'S WELL CHILD AND FAMILY CENTER, INC.

Covered Entity Details

Entity Name

ST. JOHN'S WELL CHILD AND FAMILY CENTER, INC.

Subdivision Name

SJWCFC LEWIS FRAYSER CLINIC

Type

HRSA-Funded Health Center

340B ID

CH091037D

Entity Address

5701 S. Hoover St
Los Angeles, CA 90037

Grant Number

H80CS00873

Participating Start Date

4/1/2005

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

MORNINGSIDE MEDICAL PHARMACY INC

Pharmacy Address

MORNINGSIDE MEDICAL PHARMACY
1704 W. MANCHESTER AVE,
LOS ANGELES, CA 90047

Pharmacy Comments

Contract Details

Approval Date

1/6/2011

Contract Begin Date

1/11/2011

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/31/2015
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

1/3/2011

340B Drug Pricing Program Database