340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ABC PHARMACY
FQHCLA397A Health Service Alliance
Print
Covered Entity Details
Entity Name
Health Service Alliance
Subdivision Name
Montclair Community Health Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA397A
Entity Address
5050 San Bernardino St
Montclair, CA 91763-2326
Grant Number
LALCS33333
Participating Start Date
10/1/2019
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
ABC PHARMACY
Pharmacy Address
3907 CHICAGO AVE STE A
RIVERSIDE, CA 92507
Pharmacy Comments
Contract Details
Approval Date
7/16/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Terry Chase, Chief Executive Officer
(909) 465-7193
Contract Pharmacy Representative
ABC Pharmacy
Jonathan Chan, Pharmacy Director
(909) 285-1118
Signed By Date
7/16/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session