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MEDEX PHARMACIES
CHC10607-02 COMPREHENSIVE COMMUNITY HEALTH CENTERS, INC
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Covered Entity Details
Entity Name
COMPREHENSIVE COMMUNITY HEALTH CENTERS, INC
Subdivision Name
Comprehensive Community Health Centers, Inc-North Hollywood
Type
HRSA-Funded Health Center
340B ID
CHC10607-02
Entity Address
12157 Victory Blvd
North Hollywoood, CA 91606-3204
Grant Number
H80CS10607
Participating Start Date
1/1/2005
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
MEDEX PHARMACIES
Pharmacy Address
MEDEX PHARMACIES
8441 FOOTHILL BLVD
SUNLAND, CA 91040-9104
Pharmacy Comments
Contract Details
Approval Date
7/18/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
FLORA POLADYAN, COO
(818) 630-6106
Contract Pharmacy Representative
MedEx Pharmacies
Karina Keshishian, CEO
(818) 925-1321
Signed By Date
7/18/2024
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