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CH091037U St. John's Well Child And Family Center, Inc. (Terminated)
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Main Details
Name
St. John's Well Child And Family Center, Inc.
Subdivision Name
SJWCFC L.A. Trade Technical College Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017666
340B ID
CH091037U
Grant Number
H80CS00873
Additional Details
Current Program Status
Terminated
Registration Date
7/10/2019
Participating Start Date
10/1/2019
Participating Approval Date
8/29/2019
Last Recertification Date
1/27/2020
Termination Date
Termination Reason
4/1/2021
Site closure
Contacts
Authorizing Official
St. John's Community Health
James Mangia, CEO
(323) 541-1600 Ext: 4000
Primary Contact
St. John's Well Child and Family Center
Sam Badianat, Director of Pharmacy
(323) 541-1600 Ext: 1469
Addresses
Street Address
400 W. Washington Blvd. MA-107
Los Angeles, CA 90015-4108
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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