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COLORADO MEDICAL PHARMACY
CHC10607-03 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-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
COLORADO MEDICAL PHARMACY
Pharmacy Address
CNM PHARMACY INC
1680 COLORADO BLVD
LOS ANGELES, CA 90041
Pharmacy Comments
Contract Details
Approval Date
7/18/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
FLORA POLADYAN, COO
(818) 630-6106
Contract Pharmacy Representative
Colorado Medical Pharmacy
Haesun Grace Cho, Pharmacyst
(323) 254-6736
Signed By Date
7/18/2024
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