340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA PHARMACY 1009
CH09882F CHILDREN'S CLINIC 'SERVING CHILDREN AND THEIR FAMILIES' THE
Print
Covered Entity Details
Entity Name
CHILDREN'S CLINIC 'SERVING CHILDREN AND THEIR FAMILIES' THE
Subdivision Name
The Children's Clinic Family Health Center at Cesar Chavez Elementary School
Type
HRSA-Funded Health Center
340B ID
CH09882F
Entity Address
730 W 3rd St
Long Beach, CA 90802-2745
Grant Number
H80CS00264
Participating Start Date
10/1/2006
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1009
Pharmacy Address
PHARMEDQUEST PHARMACY SERVICES DBA AVITA
17660 LAKEWOOD BLVD
BELLFLOWER, CA 90706-6410
Pharmacy Comments
Contract Details
Approval Date
1/11/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Elisa Nicholas, Chief Executive Officer
(562) 264-3551 Ext: 5622643985
Contract Pharmacy Representative
PharMedQuest Pharmacy Services
Sam Badianat, Director of Program Management
(714) 364-1422 Ext: 104
Signed By Date
1/11/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session