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MARKET PHARMACY
CHC08241-02 MISSION CITY COMMUNITY NETWORK INC
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Covered Entity Details
Entity Name
MISSION CITY COMMUNITY NETWORK INC
Subdivision Name
Mission City Community Network - 15210 Parthenia
Type
HRSA-Funded Health Center
340B ID
CHC08241-02
Entity Address
15210 Parthenia St
North Hills, CA 91343-5305
Grant Number
H80CS08241
Participating Start Date
4/1/2013
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MARKET PHARMACY
Pharmacy Address
9250 RESEDA BLVD STE 2C
NORTHRIDGE, CA 91324-5215
Pharmacy Comments
Contract Details
Approval Date
10/6/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nik Gupta, CEO
(818) 895-3100
Contract Pharmacy Representative
Market Pharmacy
ARMEN TATEVOSSIAN, PHARMACIST
(818) 701-7777
Signed By Date
10/6/2014
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