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FQHCLA409 AMH COMPREHENSIVE MEDICAL CENTERS (Active)
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Main Details
Name
AMH COMPREHENSIVE MEDICAL CENTERS
Subdivision Name
AMH Comprehensive Medical Centers - Alvarado
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-030255
340B ID
FQHCLA409
Grant Number
LALCS33896
Additional Details
Current Program Status
Active
Registration Date
4/13/2021
Participating Start Date
7/1/2021
Participating Approval Date
4/19/2021
Last Recertification Date
3/7/2025
Contacts
Authorizing Official
AMH Comperehensive Medical Centers
Jennelyn Argame, CEO
(213) 429-5264
Primary Contact
AMH Comperehensive Medical Centers
Glen Viray, Executive Administrator
(213) 484-8786
Addresses
Street Address
711 N Alvarado St Ste 101
Los Angeles, CA 90026-4016
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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Participating Start Date 7/1/2020, Termination Date 4/1/2021, Reinstatement 7/1/2021
04/14/2021
May 2025
May 2025
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