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FQHCLA442 KWANG HE WON HEALTH CENTER (Active)
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Main Details
Name
KWANG HE WON HEALTH CENTER
Subdivision Name
Kwang He Won Health Center
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-035824
340B ID
FQHCLA442
Grant Number
LALCS47458
Additional Details
Current Program Status
Active
Registration Date
1/3/2023
Participating Start Date
4/1/2023
Participating Approval Date
1/4/2023
Last Recertification Date
2/14/2025
Contacts
Authorizing Official
KWANG HE WON HEALTH CENTER
BONGJA BENA WON, CEO
(213) 385-0448
Primary Contact
KWANG HE WON HEALTH CENTER
JENNY JOH, MANAGER
(213) 385-0448
Addresses
Street Address
815 S Ardmore Ave FL 1
Los Angeles, CA 90005-2597
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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