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GWLW PHARMACY INC
CH0910140 COMMUNITY HEALTH ALLIANCE OF PASADENA
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Covered Entity Details
Entity Name
COMMUNITY HEALTH ALLIANCE OF PASADENA
Subdivision Name
COMMUNITY HEALTH ALLIANCE OF PASADENA
Type
HRSA-Funded Health Center
340B ID
CH0910140
Entity Address
1855 N Fair Oaks Ave
Pasadena, CA 91103-1620
Grant Number
H80CS04220
Participating Start Date
1/1/2004
Last Recertification Date
2/2/2023
Entity Termination Date
4/1/2024
Pharmacy Details
Pharmacy Name
GWLW PHARMACY INC
Pharmacy Address
BERRY & SWEENEY PHARMACY
1377 N FAIR OAKS AVENUE
PASADENA, CA 91103-2101
Pharmacy Comments
Contract Details
Approval Date
4/1/2006
Contract Begin Date
4/1/2006
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/13/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
2/28/2006
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