Contract Pharmacy Details

ACARIAHEALTH PHARMACY #13, INC
CHC266170-04 VIA CARE COMMUNITY HEALTH CENTER, INC.

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

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

1/1/2025
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

340B Drug Pricing Program Database