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SANTA ELENA PHARMACY
CHC10608-05 CENTRAL CITY COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
CENTRAL CITY COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Central City Community Health Center - SLA
Type
HRSA-Funded Health Center
340B ID
CHC10608-05
Entity Address
5970 S.Central Ave
Los Angeles, CA 90001-1100
Grant Number
H80CS10608
Participating Start Date
1/1/2015
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
SANTA ELENA PHARMACY
Pharmacy Address
9910 LONG BEACH BLVD
STE F
LYNWOOD, CA 90262
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sommer R Kaskowitz, Chief Nursing Officer
(323) 724-0019 Ext: 1026
Contract Pharmacy Representative
Santa Elena Pharmacy
Juana Valdez, Owner
(323) 249-8497
Signed By Date
10/13/2023
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