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RX E-FILL SOLUTIONS
FQHCLA81R NORTHEAST COMMUNITY CLINIC, INC
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Covered Entity Details
Entity Name
NORTHEAST COMMUNITY CLINIC, INC
Subdivision Name
Northeast Community Clinic
Type
Health Center Program Look-Alike
340B ID
FQHCLA81R
Entity Address
1403 LOMITA BOULEVARD, SUITE 103
Harbor City, CA 90710
Grant Number
LALCS00033
Participating Start Date
10/1/2016
Last Recertification Date
2/24/2023
Entity Termination Date
4/1/2024
Pharmacy Details
Pharmacy Name
RX E-FILL SOLUTIONS
Pharmacy Address
CARDINAL HEALTH PHARMACY SERVICES, LLC
27680 AVENUE MENTRY STE 100
VALENCIA, CA 91355
Pharmacy Comments
Contract Details
Approval Date
4/6/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/31/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
CHRISTOPHER LAU, EXECUTIVE DIRECTOR
(626) 457-6900
Contract Pharmacy Representative
Cardinal Health
Timmy Hoang, RPH
(661) 295-7124
Signed By Date
4/6/2023
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