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ACARIAHEALTH PHARMACY #13, INC
CHC266170-00 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 507 Community Health Center
Type
HRSA-Funded Health Center
340B ID
CHC266170-00
Entity Address
507 S. Atlantic Blvd.
Los Angeles, CA 90022-2621
Grant Number
H80CS26617
Participating Start Date
4/1/2014
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
ACARIAHEALTH PHARMACY #13, INC
Pharmacy Address
3302 GARFIELD AVE.
COMMERCE, CA 90040-3102
Pharmacy Comments
Contract Details
Approval Date
1/4/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2024
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
Acaria Health
Philip Gofman, Regional VP
(917) 312-5263
Signed By Date
1/4/2018
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