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COMMUNITY HEALTH CENTERS OF AMERICA
FQHCLA420 COMMUNITY HEALTH CENTERS OF AMERICA
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF AMERICA
Subdivision Name
CHCA Mariposa
Type
Health Center Program Look-Alike
340B ID
FQHCLA420
Entity Address
5320 State Highway 49 N Ste 1
Mariposa, CA 95338-9588
Grant Number
LALCS40180
Participating Start Date
7/1/2024
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
COMMUNITY HEALTH CENTERS OF AMERICA
Pharmacy Address
517 W MAIN ST STE B
LIVINGSTON, CA 95334-1427
Pharmacy Comments
Contract Details
Approval Date
10/14/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/1/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Gurdeep Singh, CEO
(209) 761-0134
Contract Pharmacy Representative
Community Health Centers of America
Gurdeep Singh, CEO
(209) 761-0134
Signed By Date
10/14/2021
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