Contract Pharmacy Details

GARFIELD BEACH CVS, L.L.C.
CH0925360 JWCH INSTITUTE, INC.

Covered Entity Details

Entity Name

JWCH INSTITUTE, INC.

Subdivision Name

JWCH Institute Corporate Headquarters

Type

HRSA-Funded Health Center

340B ID

CH0925360

Entity Address

5650 JILLSON ST
COMMERCE, CA 90040-1482

Grant Number

H80CS06673

Participating Start Date

9/16/2005

Last Recertification Date

2/19/2025

Pharmacy Details

Pharmacy Name

GARFIELD BEACH CVS, L.L.C.

Pharmacy Address

CVS PHARMACY # 16206
39440 10TH ST W
PALMDALE, CA 93551

Pharmacy Comments

Contract Details

Approval Date

7/11/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

ALVARO BALLESTEROS, EXECUTIVE DIRECTOR
(323) 201-4516 Ext: 3009

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/11/2019

340B Drug Pricing Program Database