Covered Entity Details

CHC33648-04 YEHOWA MEDICAL SERVICES (Active) - information as of 6/27/2025 12:30:32 AM

Main Details

Name

YEHOWA MEDICAL SERVICES

Subdivision Name

Yehowa Medical Services - Wilmington

Type

HRSA-Funded Health Center

Site ID

BPS-H80-035270

340B ID

CHC33648-04

Grant Number

H80CS33648

Additional Details

Current Program Status

Active

Registration Date

10/11/2023

Participating Start Date

1/1/2024

Participating Approval Date

10/12/2023

Last Recertification Date

2/10/2025

Contacts

Authorizing Official

Yehowa Medical Services
Thomas Tweh, Chief Executive Officer
(323) 776-1500 Ext: 1000

Primary Contact

Yehowa Medical services
Raquel Bernardino, Office Manager
(323) 776-1500 Ext: 1003

Addresses

Street Address

1037 E. Pacific Coast Highway
Wilmington, CA 90744-2726

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
CA		1801138698

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CHC33648-00	Active	BPS-H80-029622	YEHOWA MEDICAL SERVICES	Yehowa Medical Services - South Gate	5720 IMPERIAL HWY	SOUTH GATE	CA
CHC33648-01	Active	BPS-H80-029626	YEHOWA MEDICAL SERVICES	Yehowa Medical Services - Florence	1039 W Florence Ave	Los Angeles	CA
CHC33648-02	Active	BPS-H80-029623	YEHOWA MEDICAL SERVICES	Yehowa Medical Services -Vermont	11502 S. Vermont Avenue	Los Angeles	CA
CHC33648-03	Active	BPS-H80-035268	YEHOWA MEDICAL SERVICES	Yehowa Medical Services - Crenshaw	5141 Crenshaw Blvd	Los Angeles	CA
CHC33648-04	Active	BPS-H80-035270	YEHOWA MEDICAL SERVICES	Yehowa Medical Services - Wilmington	1037 E. Pacific Coast Highway	Wilmington	CA
CHC33648-05	Active	BPS-H80-032245	YEHOWA MEDICAL SERVICES	Yehowa Medical Services - Mobile Unit	5720 Imperial Hwy Ste N-O	South Gate	CA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CHC33648-00	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY #4019	5837 S. CENTRAL AVE.	LOS ANGELES	CA	90001	04/01/2020
CHC33648-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08835	3710 TWEEDY BOULEVARD	SOUTH GATE	CA	90280	04/01/2020
CHC33648-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08837	222 N. MARKET ST.	INGLEWOOD	CA	90301	04/01/2020
CHC33648-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09578	3120 W. IMPERIAL HWY.	INGLEWOOD	CA	90303	04/01/2020
CHC33648-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08892	5822 SOUTH VERMONT AVENUE	LOS ANGELES	CA	90044	04/01/2020	04/01/2020
CHC33648-01	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY #4019	5837 S. CENTRAL AVE.	LOS ANGELES	CA	90001	04/01/2020
CHC33648-01	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08835	3710 TWEEDY BOULEVARD	SOUTH GATE	CA	90280	04/01/2020
CHC33648-01	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08837	222 N. MARKET ST.	INGLEWOOD	CA	90301	04/01/2020
CHC33648-01	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09578	3120 W. IMPERIAL HWY.	INGLEWOOD	CA	90303	04/01/2020
CHC33648-01	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08892	5822 SOUTH VERMONT AVENUE	LOS ANGELES	CA	90044	04/01/2020	04/01/2020
CHC33648-02	GARFIELD BEACH CVS, L.L.C.	DBA CVS/PHARMACY #4019	5837 S. CENTRAL AVE.	LOS ANGELES	CA	90001	04/01/2020
CHC33648-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08835	3710 TWEEDY BOULEVARD	SOUTH GATE	CA	90280	04/01/2020
CHC33648-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08837	222 N. MARKET ST.	INGLEWOOD	CA	90301	04/01/2020
CHC33648-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09578	3120 W. IMPERIAL HWY.	INGLEWOOD	CA	90303	04/01/2020
CHC33648-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08892	5822 SOUTH VERMONT AVENUE	LOS ANGELES	CA	90044	04/01/2020	04/01/2020
CHC33648-00	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08892	5822 SOUTH VERMONT AVENUE	LOS ANGELES	CA	90044	07/01/2020
CHC33648-01	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08892	5822 SOUTH VERMONT AVENUE	LOS ANGELES	CA	90044	07/01/2020
CHC33648-02	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 08892	5822 SOUTH VERMONT AVENUE	LOS ANGELES	CA	90044	07/01/2020
CHC33648-00	WALGREEN CO.	DBA: WALGREENS # 07482	1800 W SLAUSON	LOS ANGELES	CA	90047-1126	04/01/2020
CHC33648-00	WALGREEN CO.	DBA: WALGREENS # 06249	4351 E IMPERIAL HWY	LYNWOOD	CA	90262	04/01/2020
CHC33648-00	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16368	3745 S LA BREA AVE STE C & D	LOS ANGELES	CA	90016	04/01/2020
CHC33648-00	WALGREEN CO.	DBA: WALGREENS #09842	8030 IMPERIAL HWY	DOWNEY	CA	90242	04/01/2020
CHC33648-00	WALGREEN CO.	DBA: WALGREENS # 06974	3331 WEST CENTURY BLVD	INGLEWOOD	CA	90303	04/01/2020
CHC33648-01	WALGREEN CO.	DBA: WALGREENS # 06249	4351 E IMPERIAL HWY	LYNWOOD	CA	90262	04/01/2020
CHC33648-01	WALGREEN CO.	DBA: WALGREENS # 06974	3331 WEST CENTURY BLVD	INGLEWOOD	CA	90303	04/01/2020
CHC33648-01	WALGREEN CO.	DBA: WALGREENS # 07482	1800 W SLAUSON	LOS ANGELES	CA	90047-1126	04/01/2020
CHC33648-01	WALGREEN CO.	DBA: WALGREENS #09842	8030 IMPERIAL HWY	DOWNEY	CA	90242	04/01/2020
CHC33648-01	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16368	3745 S LA BREA AVE STE C & D	LOS ANGELES	CA	90016	04/01/2020
CHC33648-02	WALGREEN CO.	DBA: WALGREENS # 07482	1800 W SLAUSON	LOS ANGELES	CA	90047-1126	04/01/2020
CHC33648-02	WALGREEN CO.	DBA: WALGREENS # 06974	3331 WEST CENTURY BLVD	INGLEWOOD	CA	90303	04/01/2020
CHC33648-02	WALGREEN CO.	DBA: WALGREENS #09842	8030 IMPERIAL HWY	DOWNEY	CA	90242	04/01/2020
CHC33648-02	WALGREEN CO.	DBA: WALGREENS # 06249	4351 E IMPERIAL HWY	LYNWOOD	CA	90262	04/01/2020
CHC33648-02	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16368	3745 S LA BREA AVE STE C & D	LOS ANGELES	CA	90016	04/01/2020

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/19/2024 1:12:38 PM	2/10/2025 3:28:25 PM	2/10/2025 3:28 PM
Details	Last Recertification Date	Update	Recertification		2/19/2024 1:12:38 PM	2/19/2024 1:12 PM
Details	State	Update		Approved	Active	1/1/2024 12:01 AM
Contacts	Signed By	Insert	New Registration		Tweh, Thomas Chief Executive Officer Yehowa Medical Services 3237761500-1000	10/12/2023 1:32 PM
Details	340B ID	Update	New Registration		CHC33648-04	10/12/2023 1:32 PM
Dates	Participating Approval Date	Update	New Registration		10/12/2023 1:32:23 PM	10/12/2023 1:32 PM
Details	State	Update	New Registration	Pending	Approved	10/12/2023 1:32 PM
Dates	Signed By Date	Update	New Registration		10/11/2023 6:36:53 PM	10/12/2023 1:32 PM
Dates	Start Date	Update	New Registration		1/1/2024 12:00:00 AM	10/12/2023 1:32 PM
Addresses	Main Address	Insert	New Registration		1037 E. Pacific Coast Highway Wilmington, CA 90744-2726	10/11/2023 6:36 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1801138698	10/11/2023 6:36 PM
Medicaid Billing	NPI: State	Insert	New Registration		CA	10/11/2023 6:36 PM
Contacts	Authorizing Official	Insert	New Registration		Tweh, Thomas Chief Executive Officer Yehowa Medical Services 3237761500-1000	10/11/2023 6:36 PM
Contacts	Primary Contact	Insert	New Registration		Bernardino, Raquel Office Manager Yehowa Medical services 3237761500-1003	10/11/2023 6:36 PM
Details	Assistance Received From Date	Insert	New Registration			10/11/2023 6:36 PM
Details	Assistance Received To Date	Insert	New Registration			10/11/2023 6:36 PM
Details	Last Recertification Date	Insert	New Registration			10/11/2023 6:36 PM
Details	Grant Number	Insert	New Registration		H80CS33648	10/11/2023 6:36 PM
Details	340B ID	Insert	New Registration			10/11/2023 6:36 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/11/2023 6:36 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/11/2023 6:36 PM
Details	Medicare Provider Number	Insert	New Registration			10/11/2023 6:36 PM
Details	Entity Name	Insert	New Registration		YEHOWA MEDICAL SERVICES	10/11/2023 6:36 PM
Details	NOFO Number	Insert	New Registration			10/11/2023 6:36 PM
Details	Program Code	Insert	New Registration		CH	10/11/2023 6:36 PM
Details	Entity Subname	Insert	New Registration		Yehowa Medical Services - Wilmington	10/11/2023 6:36 PM
Dates	Participating Approval Date	Insert	New Registration			10/11/2023 6:36 PM
Details	State	Insert	New Registration		Pending	10/11/2023 6:36 PM
Dates	Registration Date	Insert	New Registration		10/11/2023 6:36:50 PM	10/11/2023 6:36 PM
Dates	Signed By Date	Insert	New Registration			10/11/2023 6:36 PM
Dates	Start Date	Insert	New Registration			10/11/2023 6:36 PM
Terminations	Termination Comments	Insert	New Registration			10/11/2023 6:36 PM
Terminations	Termination Date	Insert	New Registration			10/11/2023 6:36 PM
Terminations	Termination Effective Date	Insert	New Registration			10/11/2023 6:36 PM
Terminations	Termination Reason	Insert	New Registration			10/11/2023 6:36 PM

340B Drug Pricing Program Database