Contract Pharmacy Details

PHARMEDQUEST PHARMACY
CH092536S JWCH INSTITUTE, INC.

Covered Entity Details

Entity Name

JWCH INSTITUTE, INC.

Subdivision Name

JWCH Medical Clinic @ Bell Shelter

Type

HRSA-Funded Health Center

340B ID

CH092536S

Entity Address

5600 Rickenbacker Road, Bldg. E-1
Bell, CA 90201

Grant Number

H80CS06673

Participating Start Date

1/1/2015

Last Recertification Date

2/15/2023

Entity Termination Date

4/1/2024

Pharmacy Details

Pharmacy Name

PHARMEDQUEST PHARMACY

Pharmacy Address

PHARMEDQUEST PHARMACY SERVICES
451 W. LAMBERT RD STE 209
BREA, CA 92821-9282

Pharmacy Comments

Contract Details

Approval Date

7/10/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/31/2020
Business decision by covered entity and/or pharmacy

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

340B Drug Pricing Program Database