Contract Pharmacy Details

ATLANTIC PHARMACY
FP900228 Via Care Community Health Center

Covered Entity Details

Entity Name

Via Care Community Health Center

Subdivision Name

Garfield High School Wellness Center

Type

Family Planning (Title X only)

340B ID

FP900228

Entity Address

501 South Woods
Los Angeles, CA 90022

Grant Number

FPHPA006537

Participating Start Date

10/1/2013

Last Recertification Date

5/6/2024

Entity Termination Date

7/1/2024

Pharmacy Details

Pharmacy Name

ATLANTIC PHARMACY

Pharmacy Address

5119 E. BEVERLY BLVD.
LOS ANGELES, CA 90022-1734

Pharmacy Comments

Contract Details

Approval Date

10/9/2015

Contract Begin Date

1/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Joe Gotsill, CFO
(323) 268-9191

Contract Pharmacy Representative

Rosa Garcia, Pharmacy Manager
(323) 264-5060

Signed By Date

10/9/2015