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RALPHS GROCERY CO
RWI93536 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
High Desert Multi-Service Ambulatory Care Center
Type
Ryan White Part A
340B ID
RWI93536
Entity Address
335 East Ave I
Lancaster, CA 93535
Grant Number
H89HA00016
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 #147
27760 N. MCBEAN PKWY
VALENCIA, CA 91354
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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