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FQHCLA341 YEHOWA MEDICAL SERVICES (Terminated)
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Main Details
Name
YEHOWA MEDICAL SERVICES
Subdivision Name
Yehowa Medical Services
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-018012
340B ID
FQHCLA341
Grant Number
LALCS00179
Additional Details
Current Program Status
Terminated
Registration Date
7/7/2016
Participating Start Date
10/1/2016
Participating Approval Date
7/29/2016
Last Recertification Date
2/6/2019
Termination Date
Termination Reason
4/1/2020
Failure to recertify
Contacts
Authorizing Official
Yehowa Medical Services
Thomas Tweh, Chief Executive Officer
(323) 776-1500 Ext: 1000
Primary Contact
Yehowa Medical services
Raquel Bernardino, Office Manager
(323) 776-1500 Ext: 1003
Addresses
Street Address
1039 W FLORENCE AVE
LOS ANGELES, CA 90044-2441
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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