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RX E-FILL SOLUTIONS
FQHCLA81D NORTHEAST COMMUNITY CLINIC
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Covered Entity Details
Entity Name
NORTHEAST COMMUNITY CLINIC
Subdivision Name
FOSHAY LEARNING CENTER
Type
Health Center Program Look-Alike
340B ID
FQHCLA81D
Entity Address
3751 S HARVARD BLVD
LOS ANGELES, CA 90018
Grant Number
LALCS00033
Participating Start Date
4/1/2011
Last Recertification Date
2/21/2017
Entity Termination Date
1/1/2018
Pharmacy Details
Pharmacy Name
RX E-FILL SOLUTIONS
Pharmacy Address
28341 CONSTELLATION RD
SANTA CLARITA, CA 91355
Pharmacy Comments
Contract Details
Approval Date
1/13/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
CHRISTOPHER LAU, EXECUTIVE DIRECTOR
(626) 457-6900
Contract Pharmacy Representative
Cardinal Health Pharmacy
Robert Kulis, SVP GM Pharmacy Solutions
(281) 749-4083
Signed By Date
1/13/2016
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