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OLIVE BRANCH PHARMACY
CHC28985-00 CENTRAL NEIGHBORHOOD HEALTH FOUNDATION
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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
OLIVE BRANCH PHARMACY
Pharmacy Address
2811 S. SAN PEDRO ST
LOS ANGELES, CA 90011
Pharmacy Comments
Contract Details
Approval Date
1/13/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bassett Brown, Chief Executive Officer
(626) 252-5646
Contract Pharmacy Representative
Olive Branch Pharmacy
redda alhousayni, pharmacist
(213) 536-4888
Signed By Date
1/13/2018
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