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PHARMACY OF THE DESERT
CHC10608-00 CENTRAL CITY COMMUNITY HEALTH CENTER, INC
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Covered Entity Details
Entity Name
CENTRAL CITY COMMUNITY HEALTH CENTER, INC
Subdivision Name
Central City Community Health Center, Inc. - Anaheim
Type
HRSA-Funded Health Center
340B ID
CHC10608-00
Entity Address
2237 W.Ball Road
Anaheim, CA 92804-5314
Grant Number
H80CS10608
Participating Start Date
7/1/2024
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
PHARMACY OF THE DESERT
Pharmacy Address
79440 HIGHWAY 111 STE 103
#103
LA QUINTA, CA 92253
Pharmacy Comments
Contract Details
Approval Date
10/16/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/15/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Sommer R Kaskowitz, Chief Nursing Officer
(323) 724-0019 Ext: 1026
Contract Pharmacy Representative
Pharmacy of the Desert
Doris Khalil, Director
(760) 777-1115
Signed By Date
10/16/2017
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