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RX E-FILL SOLUTIONS
CH09100AH NORTHEAST VALLEY HEALTH CORPORATION
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Covered Entity Details
Entity Name
NORTHEAST VALLEY HEALTH CORPORATION
Subdivision Name
Northeast Valley Health Corporation Mobile
Type
HRSA-Funded Health Center
340B ID
CH09100AH
Entity Address
1172 N. Maclay Ave
San Fernando, CA 91340-1328
Grant Number
H80CS00139
Participating Start Date
4/1/2013
Last Recertification Date
1/30/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
RX E-FILL SOLUTIONS
Pharmacy Address
28341 CONSTELLATION RD
SANTA CLARITA, CA 91355
Pharmacy Comments
Contract Details
Approval Date
1/5/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kimberly Wyard, Chief Executive Officer
(818) 898-1388 Ext: 41620
Contract Pharmacy Representative
Cardinal Health
Hazma Tarazi, Consultant
(614) 757-0386
Signed By Date
1/5/2018
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