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CAPITOL DRUGS - SHERMAN OAKS
STD90008 Being Alive People with AIDS Action Coalition Inc
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Covered Entity Details
Entity Name
Being Alive People with AIDS Action Coalition Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD90008
Entity Address
3756 Santa Rosalia Drive
506
Los Angeles, CA 90008
Grant Number
6NU62PS924569
Participating Start Date
7/1/2024
Last Recertification Date
5/6/2025
Pharmacy Details
Pharmacy Name
CAPITOL DRUGS - SHERMAN OAKS
Pharmacy Address
4454 VAN NUYS BLVD
STE J
SHERMAN OAKS, CA 91403
Pharmacy Comments
Contract Details
Approval Date
6/10/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jamie Baker, Director
(323) 874-4322
Contract Pharmacy Representative
VLS Capitol Drugs, Inc.
Raja Sannidhi, President
(310) 289-1125
Signed By Date
4/3/2024
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