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WELLPARTNER, INC
CHC24115-00 SABAN FREE CLINIC, THE
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Covered Entity Details
Entity Name
SABAN FREE CLINIC, THE
Subdivision Name
Beverly Health Center
Type
HRSA-Funded Health Center
340B ID
CHC24115-00
Entity Address
8405 Beverly Blvd.
Los Angeles, CA 90048-3401
Grant Number
H80CS24115
Participating Start Date
10/1/2012
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WELLPARTNER, INC
Pharmacy Address
20800 SW 115TH AVE
SUITE 100
TUALATIN, OR 97062
Pharmacy Comments
Contract Details
Approval Date
7/18/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/3/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Julie Hudman, CEO
(323) 330-1660
Contract Pharmacy Representative
Wellpartner, inc
Harish Thiagaraj, Senior Vice President of Pharmacy/Specialty Pharmacy
(503) 906-6887
Signed By Date
7/18/2017
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