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CH092536W JWCH INSTITUTE, INC. (Terminated)
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Main Details
Name
JWCH INSTITUTE, INC.
Subdivision Name
Wesley Health Centers - Lynwood #2
Type
HRSA-Funded Health Center
Site ID
BPS-H80-012390
340B ID
CH092536W
Grant Number
H80CS06673
Additional Details
Current Program Status
Terminated
Registration Date
10/1/2014
Participating Start Date
1/1/2015
Participating Approval Date
10/16/2014
Last Recertification Date
2/14/2018
Termination Date
Termination Reason
7/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
JWCH Institute
ALVARO BALLESTEROS, EXECUTIVE DIRECTOR
(323) 201-4516 Ext: 3009
Primary Contact
JWCH INSTITUTE, INC
Andy Irie, Chief Administrative Officer
(323) 201-4516 Ext: 3011
Addresses
Street Address
3580 E Imperial Hwy
Lynwood, CA 90262-2602
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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