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CAPITOL DRUGS - WEST HOLLYWOOD
CHC26621-00 Los Angeles Gay And Lesbian Community Services Center
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Covered Entity Details
Entity Name
Los Angeles Gay And Lesbian Community Services Center
Subdivision Name
The Los Angeles Gay & Lesbian Center
Type
HRSA-Funded Health Center
340B ID
CHC26621-00
Entity Address
1625 Schrader Blvd
Los Angeles, CA 90028-6213
Grant Number
H80CS26621
Participating Start Date
7/1/2014
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
CAPITOL DRUGS - WEST HOLLYWOOD
Pharmacy Address
8578 SANTA MONICA BLVD
WEST HOLLYWOOD, CA 90069
Pharmacy Comments
Contract Details
Approval Date
4/8/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robyn Goldman, Chief Financial Officer
(323) 993-8948
Contract Pharmacy Representative
VLS Capitol Drugs, Inc.
Raja Sannidhi, President
(310) 289-1125
Signed By Date
4/8/2024
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