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PHARMEDQUEST PHARMACY SERVICES
CH092536AE JWCH Institute, Inc.
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Covered Entity Details
Entity Name
JWCH Institute, Inc.
Subdivision Name
JWCH Institute, Inc., Mini House Residential Treatment
Type
HRSA-Funded Health Center
340B ID
CH092536AE
Entity Address
303 E 52nd St
Los Angeles, CA 90011-4513
Grant Number
H80CS06673
Participating Start Date
7/1/2018
Last Recertification Date
2/23/2025
Pharmacy Details
Pharmacy Name
PHARMEDQUEST PHARMACY SERVICES
Pharmacy Address
451 W LAMBERT RD STE 208
BREA, CA 92821-3920
Pharmacy Comments
10/17/2013- updated pharmacy name/address (was PharMed Quest Pharmacy Services Inc., dba Watts Clinic Pharmacy 471 W. LAMBERT ROAD STE 111)
Contract Details
Approval Date
7/10/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ALVARO BALLESTEROS, EXECUTIVE DIRECTOR
(323) 201-4516 Ext: 3009
Contract Pharmacy Representative
PharMedQuest
Jerry Chang, Pharmacist
(714) 364-4008 Ext: 104
Signed By Date
7/10/2018
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