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LOS ANGELES CHRISTIAN HEALTH CENTERS
CH092143V LOS ANGELES CHRISTIAN HEALTH CENTERS
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Covered Entity Details
Entity Name
LOS ANGELES CHRISTIAN HEALTH CENTERS
Subdivision Name
Los Angeles Christian Health Centers-Exodus Recovery/Marengo
Type
HRSA-Funded Health Center
340B ID
CH092143V
Entity Address
1920 Marengo Street (Exam Rm 1 & 2)
Los Angeles, CA 90033
Grant Number
H80CS06674
Participating Start Date
1/1/2014
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
LOS ANGELES CHRISTIAN HEALTH CENTERS
Pharmacy Address
1625 E 4TH ST
LOS ANGELES, CA 90033
Pharmacy Comments
Contract Details
Approval Date
10/15/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/21/2018
Agreement registered in error
Contacts
Covered Entity Signing Official
Lisa Abdishoo, President & CEO
(213) 893-1960
Contract Pharmacy Representative
Los Angeles Christian Health Centers
Kelly Chen, Pharmacy Director
(323) 268-8391
Signed By Date
10/15/2015
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