Contract Pharmacy Details

MED-CARE RX PHARMACY
CHC28368-00 SOUTHERN CALIFORNIA MEDICAL CENTER, INC.

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

MED-CARE RX PHARMACY

Pharmacy Address

14550 HAYNES ST SUITE #200A
VAN NUYS, CA 91411

Pharmacy Comments

Contract Details

Approval Date

4/12/2017

Contract Begin Date

7/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/5/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Sheila Busheri, CEO
(818) 324-3780

Contract Pharmacy Representative

MedCare Pharmacy
Mohammad Hassani, PIC/President
(818) 650-6799

Signed By Date

4/12/2017

340B Drug Pricing Program Database