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FQHCLA82B White Memorial Community Health Center, A California Nonprofit Public Benef (Active)
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Main Details
Name
White Memorial Community Health Center, A California Nonprofit Public Benef
Subdivision Name
WMCHC - Family Practice - Suite 4300
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-031123
340B ID
FQHCLA82B
Grant Number
LALCS31625
Additional Details
Current Program Status
Active
Registration Date
10/12/2020
Participating Start Date
1/1/2021
Participating Approval Date
11/24/2020
Last Recertification Date
2/24/2025
Contacts
Authorizing Official
White Memorial Community Health Center
Grace Floutsis, Chief Medical Officer
(323) 987-1222
Primary Contact
White Memorial Community Health Center
Ingrid Anzueto, Executive Assistant
(323) 859-3627
Addresses
Street Address
1828 E Cesar E Chavez Ave Ste 4300
Los Angeles, CA 90033-2400
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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