340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
EVERGREEN RX INC
CHC28987-12 COMPLETE CARE COMMUNITY HEALTH CENTER, INC.
Print
Covered Entity Details
Entity Name
COMPLETE CARE COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Complete Care Community Health Center-Simi Valley
Type
HRSA-Funded Health Center
340B ID
CHC28987-12
Entity Address
1350 E. Los Angeles Ave. STE 100
Simi Valley, CA 93065
Grant Number
H80CS28987
Participating Start Date
10/1/2023
Last Recertification Date
1/30/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
EVERGREEN RX INC
Pharmacy Address
DBA MEDICO PHARMACY
11779 SANTA MONICA BLVD
LOS ANGELES, CA 90025
Pharmacy Comments
Contract Details
Approval Date
7/10/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Karen Akopian, Vice President
(310) 730-6362
Contract Pharmacy Representative
Evergreen Rx Inc dba Medico Pharmacy
Alice Geisman, Pharmacist
(310) 444-9011
Signed By Date
7/7/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session