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CH091037B ST. JOHN'S WELL CHILD AND FAMILY CENTER, INC. (Active)
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Main Details
Name
ST. JOHN'S WELL CHILD AND FAMILY CENTER, INC.
Subdivision Name
ABRAHAM LINCOLN SBHC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005389
340B ID
CH091037B
Grant Number
H80CS00873
Additional Details
Current Program Status
Active
Registration Date
8/9/2011
Participating Start Date
10/1/2011
Participating Approval Date
9/5/2011
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
2512 Alta St
Los Angeles, CA 90031-2457
Billing Address
ST. JOHN'S WELL CHILD AND FAMILY CENTER
808 W. 58th St.
Los Angeles, CA 90037
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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10/7/08 UPDATED ADDR. (WAS 514 WEST ADAMS STREET)
08/09/2011
May 2025
May 2025
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