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SANTA MARIA PHARMACY INC
CHC28368-00 SOUTHERN CALIFORNIA MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
SOUTHERN CALIFORNIA MEDICAL CENTER, INC.
Subdivision Name
Southern California Medical Center (EM)
Type
HRSA-Funded Health Center
340B ID
CHC28368-00
Entity Address
12100 VALLEY BLVD
EL MONTE, CA 91732-3100
Grant Number
H80CS28368
Participating Start Date
10/1/2015
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SANTA MARIA PHARMACY INC
Pharmacy Address
DBA SANTA MARIA COMMUNITY PHARMACY
11004 VALLEY MALL
EL MONTE, CA 91731
Pharmacy Comments
Contract Details
Approval Date
10/8/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sheila Busheri, CEO
(818) 324-3780
Contract Pharmacy Representative
Santa Maria Pharmacy
Marcos Soleman, Owner
(626) 443-3089
Signed By Date
10/8/2015
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