Contract Pharmacy Details

GLESENER PHARMACY
CHC08241-09 MISSION CITY COMMUNITY NETWORK, INC.

Covered Entity Details

Entity Name

MISSION CITY COMMUNITY NETWORK, INC.

Subdivision Name

Mission City Community Network - Mobile-San Gabriel Valley

Type

HRSA-Funded Health Center

340B ID

CHC08241-09

Entity Address

1818 N ORANGE GROVE AVE
POMONA, CA 91767-3028

Grant Number

H80CS08241

Participating Start Date

7/1/2016

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

GLESENER PHARMACY

Pharmacy Address

321 NORTH CITRUS STREET
COVINA, CA 91723

Pharmacy Comments

Contract Details

Approval Date

4/15/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/15/2021
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Nik Gupta, CEO
(818) 895-3100

Contract Pharmacy Representative

Laura Scarbrough, COO
(626) 966-3691

Signed By Date

4/15/2016

340B Drug Pricing Program Database