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PHARMEDQUEST PHARMACY
CH092536N JWCH INSTITUTE, INC.
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Covered Entity Details
Entity Name
JWCH INSTITUTE, INC.
Subdivision Name
JWCH MOBILE MEDICAL CLINIC
Type
HRSA-Funded Health Center
340B ID
CH092536N
Entity Address
515 E 6th St
Los Angeles, CA 90021-1009
Grant Number
H80CS06673
Participating Start Date
1/1/2015
Last Recertification Date
2/19/2025
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
10/1/2021
Pharmacy closed
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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