340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ACTON VALE PHARMACY
CHC26613-00 ANTELOPE VALLEY COMMUNITY CLINIC
Print
Covered Entity Details
Entity Name
ANTELOPE VALLEY COMMUNITY CLINIC
Subdivision Name
Antelope Valley Community Clinic - Health and Wellness Center
Type
HRSA-Funded Health Center
340B ID
CHC26613-00
Entity Address
45104 10th St W
Lancaster, CA 93534-2310
Grant Number
H80CS26613
Participating Start Date
4/1/2014
Last Recertification Date
2/1/2019
Entity Termination Date
10/1/2019
Pharmacy Details
Pharmacy Name
ACTON VALE PHARMACY
Pharmacy Address
THE BAIDEN GROUP INC.
3630 SMITH AVE
SUITE A
ACTON, CA 93510
Pharmacy Comments
Contract Details
Approval Date
4/3/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
James A. Cook, CEO
(661) 942-2391
Contract Pharmacy Representative
Acton Vale Pharmacy
Amma Amihyia, Owner
(661) 269-9911
Signed By Date
4/3/2014
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session