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RX E-FILL SOLUTIONS
CH09100AD NORTHEAST VALLEY HEALTH CORPORATION
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Covered Entity Details
Entity Name
NORTHEAST VALLEY HEALTH CORPORATION
Subdivision Name
LAC-CANOGA PARK HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH09100AD
Entity Address
7107 Remmet Ave
Canoga Park, CA 91303-2016
Grant Number
H80CS00139
Participating Start Date
4/1/2013
Last Recertification Date
2/11/2025
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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