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GARFIELD BEACH CVS, L.L.C.
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
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09694
900 N. LAKE AVE.
PASADENA, CA 91104
Pharmacy Comments
Contract Details
Approval Date
4/4/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/13/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
MARGARET B. MARTINEZ, Chief Executive Officer
(626) 993-1227
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/4/2017
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