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AP9 PHARMACY
CH09311AV ALTAMED HEALTH SERVICES CORPORATION
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Covered Entity Details
Entity Name
ALTAMED HEALTH SERVICES CORPORATION
Subdivision Name
AltaMed Medical Group - Huntington Park
Type
HRSA-Funded Health Center
340B ID
CH09311AV
Entity Address
1900 E SLAUSON AVE
HUNTINGTON PARK, CA 90255-2725
Grant Number
H80CS00142
Participating Start Date
4/1/2016
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
AP9 PHARMACY
Pharmacy Address
PHARMEDQUEST PHARMACY SERVICES
1900 E. SLAUSON AVE.
HUNTINGTON PARK, CA 90255-2725
Pharmacy Comments
Contract Details
Approval Date
1/11/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jose Esparza, Sr. VP, Finance & CFO
(323) 889-7320
Contract Pharmacy Representative
AltaMed
Duane Saikami, Pharmacist
(714) 364-1411
Signed By Date
1/11/2016
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