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ST MARY & ST PHILOMENA INC
CHC28366-00 HARBOR COMMUNITY CLINIC
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Covered Entity Details
Entity Name
HARBOR COMMUNITY CLINIC
Subdivision Name
6th Street Health Center
Type
HRSA-Funded Health Center
340B ID
CHC28366-00
Entity Address
593 West 6th Street
San Pedro, CA 90731
Grant Number
H80CS28366
Participating Start Date
1/1/2016
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
ST MARY & ST PHILOMENA INC
Pharmacy Address
DBA SEASIDE PHARMACY
599 W 7TH ST STE A
SAN PEDRO, CA 90731
Pharmacy Comments
Contract Details
Approval Date
4/11/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nathalia Jimenez, COO
(310) 547-0202 Ext: 134
Contract Pharmacy Representative
St Mary & St Philomena Inc
Elizabeth Reyes, Administrator
(626) 254-3047
Signed By Date
4/11/2022
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