Contract Pharmacy Details

RX E-FILL SOLUTIONS
CHC08241-23 MISSION CITY COMMUNITY NETWORK, INC.

Covered Entity Details

Entity Name

MISSION CITY COMMUNITY NETWORK, INC.

Subdivision Name

Mission City Community Network - Maywood

Type

HRSA-Funded Health Center

340B ID

CHC08241-23

Entity Address

5800 King Avenue
Maywood, CA 90270

Grant Number

H80CS08241

Participating Start Date

1/1/2018

Last Recertification Date

1/28/2020

Entity Termination Date

1/1/2021

Pharmacy Details

Pharmacy Name

RX E-FILL SOLUTIONS

Pharmacy Address

28341 CONSTELLATION RD
SANTA CLARITA, CA 91355

Pharmacy Comments

Contract Details

Approval Date

1/9/2018

Contract Begin Date

4/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2021
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Nik Gupta, CEO
(818) 895-3100

Contract Pharmacy Representative

DHS
Shane D'Souza, Pharmacy Services Chief II
(213) 240-7717

Signed By Date

1/9/2018

340B Drug Pricing Program Database