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MANCHESTER PROFESSIONAL PHARMACY
FP900083 T.H.E. CLINIC INC
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Covered Entity Details
Entity Name
T.H.E. CLINIC INC
Subdivision Name
CLINIC
Type
Family Planning (Title X only)
340B ID
FP900083
Entity Address
3834 SOUTH WESTERN AVENUE
LOS ANGELES, CA 90062
Grant Number
FPHPA006537
Participating Start Date
1/1/1998
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
MANCHESTER PROFESSIONAL PHARMACY
Pharmacy Address
NO APARTMENT
600 W MANCHESTER AVE
LOS ANGELES, CA 90044-5770
Pharmacy Comments
Contract Details
Approval Date
1/9/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Clifford Shiepe, President and CEO
(323) 730-1920 Ext: 3053
Contract Pharmacy Representative
Hawthorne Professional Pharmacy
Janice Cooper, PharmD
(213) 999-0428
Signed By Date
1/9/2018
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