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IDEAL RX LLC
CHC33794-00 HEALTH ACCESS FOR ALL INC.
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Covered Entity Details
Entity Name
HEALTH ACCESS FOR ALL INC.
Subdivision Name
Angeles Community Health Center - Huntington Park
Type
HRSA-Funded Health Center
340B ID
CHC33794-00
Entity Address
6208 Seville Ave
Huntington Park, CA 90255-2913
Grant Number
H80CS33794
Participating Start Date
1/1/2020
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
IDEAL RX LLC
Pharmacy Address
DBA SEVILLE PHARMACY
6216 SEVILLE AVE
HUNTINGTON PARK, CA 90255
Pharmacy Comments
Contract Details
Approval Date
4/16/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Peyman Banooni, CEO
(213) 228-3808
Contract Pharmacy Representative
Ideal Rx LLC
Soheil Zafarmehr, Pharmacist
(818) 388-6245
Signed By Date
4/16/2023
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