Contract Pharmacy Details

RALPHS GROCERY CO
FQHCLA81C NORTHEAST COMMUNITY CLINIC

Covered Entity Details

Entity Name

NORTHEAST COMMUNITY CLINIC

Subdivision Name

NECC - GAGE HEALTH CENTER

Type

Health Center Program Look-Alike

340B ID

FQHCLA81C

Entity Address

2975 ZOE AVE
Huntington Park, CA 90255

Grant Number

LALCS00033

Participating Start Date

4/1/2011

Last Recertification Date

2/26/2024

Entity Termination Date

4/1/2024

Pharmacy Details

Pharmacy Name

RALPHS GROCERY CO

Pharmacy Address

DBA RALPHS #295
8626 FIRESTONE BLVD
DOWNEY, CA 90241

Pharmacy Comments

Contract Details

Approval Date

6/5/2017

Contract Begin Date

7/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/19/2022
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

CHRISTOPHER LAU, EXECUTIVE DIRECTOR
(626) 457-6900

Contract Pharmacy Representative

Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672

Signed By Date

6/5/2017

340B Drug Pricing Program Database