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PREMIER PHARMACY SERVICES
CHC26614-00 APLA HEALTH & WELLNESS
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Covered Entity Details
Entity Name
APLA HEALTH & WELLNESS
Subdivision Name
APLA Health & Wellness Center
Type
HRSA-Funded Health Center
340B ID
CHC26614-00
Entity Address
3743 S. La Brea Ave.
Los Angeles, CA 90016-5309
Grant Number
H80CS26614
Participating Start Date
7/1/2014
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
PREMIER PHARMACY SERVICES
Pharmacy Address
410 CLOVERLEAF DR
BALDWIN PARK, CA 91706
Pharmacy Comments
Contract Details
Approval Date
10/10/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2023
Ownership change
Contacts
Covered Entity Signing Official
Craig E. Thompson, Chief Executive Officer
(213) 201-1456
Contract Pharmacy Representative
Ntegrous Core Corporation
Marva A. Brannum, Clinical Pharmacist
(626) 482-0707
Signed By Date
10/10/2017
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