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CBC MISSION PHARMACY
CHC26624-01 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
CHC26624-01
Entity Address
1450 E. Holt Blvd.
Pomona, CA 91767-5822
Grant Number
H80CS26624
Participating Start Date
4/1/2014
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
CBC MISSION PHARMACY
Pharmacy Address
CBC PHARMACY
716 E MISSION BLVD SUITE A
POMONA, CA 91766
Pharmacy Comments
Contract Details
Approval Date
1/16/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/31/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Ellen R. Silver, CEO
(909) 865-9501 Ext: 7939
Contract Pharmacy Representative
Bill Chung, Pharmacist
(909) 865-1149
Signed By Date
1/16/2015
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