Contract Pharmacy Details

EXPRESS PHARMACY
CHC08241-08 MISSION CITY COMMUNITY NETWORK, INC.

Covered Entity Details

Entity Name

MISSION CITY COMMUNITY NETWORK, INC.

Subdivision Name

Mission City Community Network- La Puente

Type

HRSA-Funded Health Center

340B ID

CHC08241-08

Entity Address

1025 Willow Avenue
La Puente, CA 91746

Grant Number

H80CS08241

Participating Start Date

7/1/2016

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

EXPRESS PHARMACY

Pharmacy Address

EXPRESS PHARMACY
752 E ARROW HWY
POMONA, CA 91767

Pharmacy Comments

Contract Details

Approval Date

4/10/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Nik Gupta, CEO
(818) 895-3100

Contract Pharmacy Representative

Jack Vasoya, Pharmacist
(909) 398-1289

Signed By Date

4/10/2016

340B Drug Pricing Program Database