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RALPHS GROCERY CO
RWI90813 Los Angeles County Department of Health Services
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Covered Entity Details
Entity Name
Los Angeles County Department of Health Services
Subdivision Name
Long Beach Comprehensive Health Center
Type
Ryan White Part A
340B ID
RWI90813
Entity Address
1333 Chestnut Ave
Long Beach, CA 90813
Grant Number
LOS ANGELES EMA
Participating Start Date
1/1/2012
Last Recertification Date
2/22/2022
Entity Termination Date
4/1/2023
Pharmacy Details
Pharmacy Name
RALPHS GROCERY CO
Pharmacy Address
DBA RALPHS #196
2250 E. CARSON STREET
LONG BEACH, CA 90807
Pharmacy Comments
Contract Details
Approval Date
9/5/2012
Contract Begin Date
9/5/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Amy Gutierrez, Chief Pharmacy Officer, Los Angeles County Department of Health Services
(213) 240-7717
Contract Pharmacy Representative
Kenny Kimball, VP of Marketing
(310) 884-9000
Signed By Date
7/27/2012
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