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MCCARTHY PHARMACY INC
CH09489G Venice Family Clinic
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Covered Entity Details
Entity Name
Venice Family Clinic
Subdivision Name
Venice Family Clinic - South Bay Family Health Care - Gardena
Type
HRSA-Funded Health Center
340B ID
CH09489G
Entity Address
742 W Gardena Blvd
Gardena, CA 90247-5024
Grant Number
H80CS04217
Participating Start Date
12/3/2021
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
MCCARTHY PHARMACY INC
Pharmacy Address
DBA FREEMAN MEDICAL PHARMACY
301 N PRAIRIE AVE STE 110
INGLEWOOD, CA 90301
Pharmacy Comments
Contract Details
Approval Date
11/30/2021
Contract Begin Date
12/7/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
ELIZABETH BENSON FORER, EXECUTIVE DIRECTOR
(310) 664-7901
Contract Pharmacy Representative
Freeman Medical Pharmacy
Mordechai Nikfar, Pharmacist Owner
(310) 672-7000
Signed By Date
11/29/2021
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