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ORANGE EXPRESS PHARMACY
CHC266170-04 VIA CARE COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
VIA CARE COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Via Care Primary 607
Type
HRSA-Funded Health Center
340B ID
CHC266170-04
Entity Address
607 S. Atlantic Blvd.
Los Angeles, CA 90022-9002
Grant Number
H80CS26617
Participating Start Date
4/1/2017
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
ORANGE EXPRESS PHARMACY
Pharmacy Address
GNB SERVICES INC
1233 N TUSTIN ST
ORANGE, CA 92867-5147
Pharmacy Comments
Contract Details
Approval Date
7/11/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/2/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Nina Falcetti, Director of HR
(323) 268-9191 Ext: 1091
Contract Pharmacy Representative
Orange Express Pharmacy
Nermine Ibrahim, Pharmacy manager
(714) 288-1720
Signed By Date
7/11/2017
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