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MISSION CITY COMMUNITY NETWORK, INC.-
CHC08241-05 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- Mobile Clinic - SFV
Type
HRSA-Funded Health Center
340B ID
CHC08241-05
Entity Address
8527 Sepulveda Blvd
North Hills, CA 91343-5824
Grant Number
H80CS08241
Participating Start Date
4/1/2013
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
MISSION CITY COMMUNITY NETWORK, INC.-
Pharmacy Address
COMMUNITY PHARMACY
15206 PARTHENIA STREET
NORTH HILLS, CA 91343-5305
Pharmacy Comments
Contract Details
Approval Date
4/4/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nik Gupta, CEO
(818) 895-3100
Contract Pharmacy Representative
IRIS BAO-NGOC NGUYEN, PHARMACIST
(818) 895-3100 Ext: 650
Signed By Date
4/4/2017
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