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CH091037AG ST. JOHN'S COMMUNITY HEALTH (Active)
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Main Details
Name
ST. JOHN'S COMMUNITY HEALTH
Subdivision Name
SJCH Indio Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-039167
340B ID
CH091037AG
Grant Number
H80CS00873
Additional Details
Current Program Status
Active
Registration Date
10/2/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/4/2024
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
St. John's Community Health
James Mangia, CEO
(323) 541-1600 Ext: 4000
Primary Contact
St. John Community Center
Peter Nabil Tawfik, Chief of Pharmacy Officer
(615) 957-8115
Addresses
Street Address
82025 Highway 111 UNIT 101
Indio, CA 92201-5686
Billing Address
St. John's Well Child
808 West 58th street
Los angeles, CA 90037
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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