Contract Pharmacy Details

COUNTY OF LOS ANGELES - AUDITOR CONTROLL
CH0910140 COMMUNITY HEALTH ALLIANCE OF PASADENA

Covered Entity Details

Entity Name

COMMUNITY HEALTH ALLIANCE OF PASADENA

Subdivision Name

COMMUNITY HEALTH ALLIANCE OF PASADENA

Type

HRSA-Funded Health Center

340B ID

CH0910140

Entity Address

1855 N Fair Oaks Ave
Pasadena, CA 91103-1620

Grant Number

H80CS04220

Participating Start Date

1/1/2004

Last Recertification Date

2/2/2023

Entity Termination Date

4/1/2024

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

7/7/2021

Contract Begin Date

10/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

MARGARET B. MARTINEZ, Chief Executive Officer
(626) 993-1227

Contract Pharmacy Representative

DHS Pharmacy Affairs
Rabeah Elbanna, Pharmacy Supervisor I
(213) 288-7717

Signed By Date

7/7/2021

340B Drug Pricing Program Database