Contract Pharmacy Details

BIG 1 PHARMACY
CH09316D ARROYO VISTA FAMILY HEALTH FOUNDATION

Covered Entity Details

Entity Name

ARROYO VISTA FAMILY HEALTH FOUNDATION

Subdivision Name

ARROYO VISTA FAMILY HEATLH CENTER ~ Loma Dr.

Type

HRSA-Funded Health Center

340B ID

CH09316D

Entity Address

303 SOUTH LOMA DRIVE STE 202
LOS ANGELES, CA 90017-1103

Grant Number

H80CS00374

Participating Start Date

7/1/2009

Last Recertification Date

2/16/2018

Entity Termination Date

1/1/2019

Pharmacy Details

Pharmacy Name

BIG 1 PHARMACY

Pharmacy Address

415 W VALLEY BLVD # B
SAN GABRIEL, CA 91776-3728

Pharmacy Comments

Contract Details

Approval Date

4/15/2014

Contract Begin Date

7/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2019
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Thuy Pham, CMO
(323) 254-5291 Ext: 3210

Contract Pharmacy Representative

Steven Chin, Pharmacist-in-Charge
(626) 281-2186

Signed By Date

4/15/2014

340B Drug Pricing Program Database