Contract Pharmacy Details

MARKET PHARMACY
CHC08241-17 MISSION CITY COMMUNITY NETWORK, INC.

Covered Entity Details

Entity Name

MISSION CITY COMMUNITY NETWORK, INC.

Subdivision Name

MIssion City Community Network - Northridge

Type

HRSA-Funded Health Center

340B ID

CHC08241-17

Entity Address

8363 Reseda Blvd.
Northridge, CA 91324-4623

Grant Number

H80CS08241

Participating Start Date

4/1/2017

Last Recertification Date

2/1/2022

Entity Termination Date

4/1/2023

Pharmacy Details

Pharmacy Name

MARKET PHARMACY

Pharmacy Address

9250 RESEDA BLVD STE 2C
NORTHRIDGE, CA 91324-5215

Pharmacy Comments

Contract Details

Approval Date

1/11/2017

Contract Begin Date

4/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2023
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Market Pharmacy
ARMEN TATEVOSSIAN, PHARMACIST
(818) 701-7777

Signed By Date

340B Drug Pricing Program Database