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LOS ANGELES COUNTY HEALTH SERVICES CENTRAL PHARMACY
CHC266170-00 Via Care Community Health Center, INC.
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Covered Entity Details
Entity Name
Via Care Community Health Center, INC.
Subdivision Name
Via Care 507 Community Health Center
Type
HRSA-Funded Health Center
340B ID
CHC266170-00
Entity Address
507 S. Atlantic Blvd.
Los Angeles, CA 90022-2621
Grant Number
H80CS26617
Participating Start Date
4/1/2014
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
LOS ANGELES COUNTY HEALTH SERVICES CENTRAL PHARMACY
Pharmacy Address
313 N FIGUEROA STREET
SUITE 1225
LOS ANGELES, CA 90012
Pharmacy Comments
Contract Details
Approval Date
4/6/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nina Falcetti, Credentialing and Compliance Manager
(323) 268-9191
Contract Pharmacy Representative
Olive View UCLA Medical Center
Nadrine Balady-Bouziane, Pharm.D.
(747) 210-3059
Signed By Date
4/6/2015
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