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GARFIELD BEACH CVS, L.L.C.
CHC33646-00 KOREAN COMMUNITY SERVICES, INC.
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Covered Entity Details
Entity Name
KOREAN COMMUNITY SERVICES, INC.
Subdivision Name
Korean Community Services d.b.a. KCS Health Center - Orangethorpe
Type
HRSA-Funded Health Center
340B ID
CHC33646-00
Entity Address
7212 Orangethorpe Ave Ste 9A
Buena Park, CA 90621-4668
Grant Number
H80CS33646
Participating Start Date
1/1/2020
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 16045
12100 HARBOR BLVD
GARDEN GROVE, CA 92840
Pharmacy Comments
Contract Details
Approval Date
7/14/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Ellen Ahn, Executive Director
(714) 527-6561
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/14/2021
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