Contract Pharmacy Details

KYOTO PHARMACY
CHC28985-00 CENTRAL NEIGHBORHOOD HEALTH FOUNDATION

Covered Entity Details

Entity Name

CENTRAL NEIGHBORHOOD HEALTH FOUNDATION

Subdivision Name

Central Neighborhood Health Foundation

Type

HRSA-Funded Health Center

340B ID

CHC28985-00

Entity Address

2614 S Grand Ave
Los Angeles, CA 90007-2607

Grant Number

H80CS28985

Participating Start Date

1/1/2016

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

KYOTO PHARMACY

Pharmacy Address

420 E 3RD ST STE 106
LOS ANGELES, CA 90013-1645

Pharmacy Comments

Contract Details

Approval Date

1/13/2018

Contract Begin Date

4/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/3/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Bassett Brown, Chief Executive Officer
(626) 252-5646

Contract Pharmacy Representative

Verity Solutions
kartik Joneja, 3rd party admiinistrator
(415) 260-6540

Signed By Date

1/13/2018

340B Drug Pricing Program Database