Contract Pharmacy Details

COUNTY OF LOS ANGELES - AUDITOR CONTROLL
CHC26624-02 POMONA COMMUNITY HEALTH CENTER

Covered Entity Details

Entity Name

POMONA COMMUNITY HEALTH CENTER

Subdivision Name

Winter Shelter

Type

HRSA-Funded Health Center

340B ID

CHC26624-02

Entity Address

600 S. Park Ave.
Pomona, CA 91766-3040

Grant Number

H80CS26624

Participating Start Date

4/1/2014

Last Recertification Date

2/10/2021

Entity Termination Date

4/1/2022

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

Contract Termination Date
Termination Reason

4/1/2022
Covered Entity Terminated

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

340B Drug Pricing Program Database