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CH091037N 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
SJCH Mobile #2
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013318
340B ID
CH091037N
Grant Number
H80CS00873
Additional Details
Current Program Status
Active
Registration Date
7/3/2014
Participating Start Date
10/1/2014
Participating Approval Date
7/23/2014
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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