Contract Pharmacy Details

REGIONAL CARE PHARMACY , INC.
CHC26613-02 ANTELOPE VALLEY COMMUNITY CLINIC

Covered Entity Details

Entity Name

ANTELOPE VALLEY COMMUNITY CLINIC

Subdivision Name

Antelope Valley Community Clinic - Mobile Health Clinic II

Type

HRSA-Funded Health Center

340B ID

CHC26613-02

Entity Address

45074 10th St W
Lancaster, CA 93534-2371

Grant Number

H80CS26613

Participating Start Date

4/1/2014

Last Recertification Date

2/10/2017

Entity Termination Date

4/1/2018

Pharmacy Details

Pharmacy Name

REGIONAL CARE PHARMACY , INC.

Pharmacy Address

326 E AVENUE I
LANCASTER, CA 93535

Pharmacy Comments

Contract Details

Approval Date

7/11/2016

Contract Begin Date

10/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2018
Covered Entity Terminated

Contacts

Covered Entity Signing Official

James A. Cook, CEO
(661) 942-2391

Contract Pharmacy Representative

Regional Care Pharmacy
Yemi Akao, Owner
(661) 945-4600

Signed By Date

7/11/2016

340B Drug Pricing Program Database