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INNOVA PHARMACY OF ARDEN-ARCADE
CHC24113-21 ELICA HEALTH CENTERS
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Covered Entity Details
Entity Name
ELICA HEALTH CENTERS
Subdivision Name
Elica Health Centers - Glendale
Type
HRSA-Funded Health Center
340B ID
CHC24113-21
Entity Address
2400 Glendale Ln
Sacramento, CA 95825
Grant Number
H80CS24113
Participating Start Date
7/1/2023
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
INNOVA PHARMACY OF ARDEN-ARCADE
Pharmacy Address
RETAIL PHARMACY
2400 GLENDALE LN STE A
SACRAMENTO, CA 95825
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David E Hughes, COO/CFO
(916) 569-8484 Ext: 312
Contract Pharmacy Representative
Family Discount Pharmacy
Tim Le, Owner
(916) 481-6900
Signed By Date
10/16/2023
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