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COUNTY OF LOS ANGELES - AUDITOR CONTROLL
CHC26624-00 POMONA COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
POMONA COMMUNITY HEALTH CENTER
Subdivision Name
Pomona Community Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26624-00
Entity Address
750 South Park Avenue, Room 101
Pomona, CA 91766
Grant Number
H80CS26624
Participating Start Date
4/1/2014
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
COUNTY OF LOS ANGELES - AUDITOR CONTROLL
Pharmacy Address
313 N FIGUEROA ST STE 1225
HEALTH SERVICES CENTRAL PHARMACY
LOS ANGELES, CA 90012-2602
Pharmacy Comments
Contract Details
Approval Date
1/15/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ellen R. Silver, CEO
(909) 865-9501 Ext: 7939
Contract Pharmacy Representative
Olive View UCLA Medical Center
Nadrine Balady-Bouziane, Pharm.D.
(747) 210-3059
Signed By Date
1/15/2016
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