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CH091037M 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
SJWCFC Washington High School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013173
340B ID
CH091037M
Grant Number
H80CS00873
Additional Details
Current Program Status
Active
Registration Date
1/15/2014
Participating Start Date
4/1/2014
Participating Approval Date
2/25/2014
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
1555 W 110th St
Los Angeles, CA 90047-4912
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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