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986 PHARMACY #8022
CHC28982-00 AAA COMPREHENSIVE HEALTHCARE, INC
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Covered Entity Details
Entity Name
AAA COMPREHENSIVE HEALTHCARE, INC
Subdivision Name
AAA Comprehensive Healthcare
Type
HRSA-Funded Health Center
340B ID
CHC28982-00
Entity Address
7451 Lankershim Blvd.
North Hollywood, CA 91605-2803
Grant Number
H80CS28982
Participating Start Date
7/1/2016
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
986 PHARMACY #8022
Pharmacy Address
INTERGALACTIC HEALTHCARE INC
15211 VANOWEN ST # 110
VAN NUYS, CA 91405
Pharmacy Comments
Contract Details
Approval Date
7/12/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Anna Nshanyan, CEO
(818) 503-9800
Contract Pharmacy Representative
COSMED PHARMACY INC.
James Chang, Pharmacist
(626) 319-0686
Signed By Date
7/12/2024
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