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MEDICAL CENTER PHARMACY
CHC08241-01 MISSION CITY COMMUNITY NETWORK INC
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Covered Entity Details
Entity Name
MISSION CITY COMMUNITY NETWORK INC
Subdivision Name
MCCN- Inglewood
Type
HRSA-Funded Health Center
340B ID
CHC08241-01
Entity Address
501 E Hardy St STE 110
Inglewood, CA 90301-4015
Grant Number
H80CS08241
Participating Start Date
4/1/2013
Last Recertification Date
2/12/2021
Entity Termination Date
4/1/2022
Pharmacy Details
Pharmacy Name
MEDICAL CENTER PHARMACY
Pharmacy Address
501 E HARDY ST STE 130
INGLEWOOD, CA 90301-4055
Pharmacy Comments
Contract Details
Approval Date
10/6/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Nik Gupta, CEO
(818) 895-3100
Contract Pharmacy Representative
Medical Center Pharamcy
JAMES PAI, PHARMACIST
(310) 671-7636
Signed By Date
10/6/2014
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