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COUNTY OF LOS ANGELES - AUDITOR CONTROLL
CH091014J COMMUNITY HEALTH ALLIANCE OF PASADENA
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Covered Entity Details
Entity Name
COMMUNITY HEALTH ALLIANCE OF PASADENA
Subdivision Name
ChapCare - Peck
Type
HRSA-Funded Health Center
340B ID
CH091014J
Entity Address
3703 Peck Rd.
Unit A-C
El Monte, CA 91731-3532
Grant Number
H80CS04220
Participating Start Date
10/1/2018
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
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