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LH PHARMACY INC
CH09316F ARROYO VISTA FAMILY HEALTH FOUNDATION
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Covered Entity Details
Entity Name
ARROYO VISTA FAMILY HEALTH FOUNDATION
Subdivision Name
ARROYO VISTA FAMILY HEALTH CENTER ~ Mobile Clinic
Type
HRSA-Funded Health Center
340B ID
CH09316F
Entity Address
6000 N Figueroa St
Los Angeles, CA 90042-4232
Grant Number
H80CS00374
Participating Start Date
7/1/2013
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
LH PHARMACY INC
Pharmacy Address
LINCOLN HEIGHTS PHARMACY
2417 N BROADWAY
LOS ANGELES, CA 90031
Pharmacy Comments
Contract Details
Approval Date
4/15/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2019
Pharmacy closed
Contacts
Covered Entity Signing Official
Thuy Pham, CMO
(323) 254-5291 Ext: 3210
Contract Pharmacy Representative
Keith LaFond, Pharmacy in charge
(323) 222-3332
Signed By Date
4/15/2014
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