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ALBERTSONS LLC
CHC29048-00 BEHAVIORAL HEALTH SERVICES INC
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Covered Entity Details
Entity Name
BEHAVIORAL HEALTH SERVICES INC
Subdivision Name
Behavioral Health Services - Family Health Center
Type
HRSA-Funded Health Center
340B ID
CHC29048-00
Entity Address
2501 W. El Segundo Blvd. Suite B
Hawthorne, CA 90250
Grant Number
H80CS29048
Participating Start Date
10/1/2016
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
ALBERTSONS LLC
Pharmacy Address
SAV-ON PHARMACY #3859
200 E SEPULVEDA BLVD
CARSON, CA 90745
Pharmacy Comments
Contract Details
Approval Date
4/16/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/15/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Shirley Summers, President/CEO
(310) 679-9126
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
4/16/2018
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