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ATLANTIC PHARMACY
CHC266170-02 VIA CARE COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
VIA CARE COMMUNITY HEALTH CENTER
Subdivision Name
VIA CARE CHAVEZ COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CHC266170-02
Entity Address
4755 E. Caesar Chavez Avenue
Los Angeles, CA 90022-1267
Grant Number
H80CS26617
Participating Start Date
4/1/2016
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
ATLANTIC PHARMACY
Pharmacy Address
5119 E. BEVERLY BLVD.
LOS ANGELES, CA 90022-1734
Pharmacy Comments
Contract Details
Approval Date
7/11/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nina Falcetti, Director of HR
(323) 268-9191 Ext: 1091
Contract Pharmacy Representative
Atlantic Pharmacy
Chi Cheng, Pharmacist
(323) 264-5060
Signed By Date
7/11/2017
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