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LOS ANGELES CHRISTIAN HEALTH CENTERS
CH092143N LOS ANGELES CHRISTIAN HEALTH CENTERS
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Covered Entity Details
Entity Name
LOS ANGELES CHRISTIAN HEALTH CENTERS
Subdivision Name
Los Angeles Mission- Anne Douglas Center
Type
HRSA-Funded Health Center
340B ID
CH092143N
Entity Address
303 E 5th St
Los Angeles, CA 90013-1505
Grant Number
H80CS06674
Participating Start Date
7/1/2010
Last Recertification Date
2/14/2017
Entity Termination Date
4/1/2018
Pharmacy Details
Pharmacy Name
LOS ANGELES CHRISTIAN HEALTH CENTERS
Pharmacy Address
1625 E 4TH ST
LOS ANGELES, CA 90033
Pharmacy Comments
Contract Details
Approval Date
10/15/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Lisa Abdishoo, President & CEO
(213) 893-1960
Contract Pharmacy Representative
Los Angeles Christian Health Centers
Kelly Chen, Pharmacy Director
(323) 268-8391
Signed By Date
10/15/2015
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