Contract Pharmacy Details

RX E-FILL SOLUTIONS
CH091037R ST. JOHN'S WELL CHILD AND FAMILY CENTER, INC.

Covered Entity Details

Entity Name

ST. JOHN'S WELL CHILD AND FAMILY CENTER, INC.

Subdivision Name

Leavey Community Clinic

Type

HRSA-Funded Health Center

340B ID

CH091037R

Entity Address

3628 E. Imperial Hwy, Suite 301
Lynwood, CA 90262-2646

Grant Number

H80CS00873

Participating Start Date

10/1/2014

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

RX E-FILL SOLUTIONS

Pharmacy Address

28341 CONSTELLATION RD
SANTA CLARITA, CA 91355

Pharmacy Comments

Contract Details

Approval Date

10/17/2016

Contract Begin Date

1/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/3/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

James Mangia, CEO
(323) 541-1600 Ext: 4000

Contract Pharmacy Representative

Olive View UCLA Medical Center
Nadrine Balady-Bouziane, Pharm.D.
(747) 210-3059

Signed By Date

10/17/2016

340B Drug Pricing Program Database