Contract Pharmacy Details

MEDEX PHARMACIES
CHC10607-03 COMPREHENSIVE COMMUNITY HEALTH CENTERS, INC

Covered Entity Details

Entity Name

COMPREHENSIVE COMMUNITY HEALTH CENTERS, INC

Subdivision Name

Comprehensive Community Health Centers, Inc-Eagle Rock

Type

HRSA-Funded Health Center

340B ID

CHC10607-03

Entity Address

1704 Colorado Blvd
Los Angeles, CA 90041-1338

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

340B Drug Pricing Program Database