340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA PHARMACY 1002
CH092536AC JWCH INSTITUTE, INC.
Print
Covered Entity Details
Entity Name
JWCH INSTITUTE, INC.
Subdivision Name
Wesley Health Center -- Hacienda Heights
Type
HRSA-Funded Health Center
340B ID
CH092536AC
Entity Address
15898 GALE AVE
HACIENDA HEIGHTS, CA 91745-1601
Grant Number
H80CS06673
Participating Start Date
7/1/2016
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1002
Pharmacy Address
PHARMEDQUEST PHARMACY SERVICES DBA AVITA
954 N VERMONT AVE # 132
LOS ANGELES, CA 90029-3529
Pharmacy Comments
Contract Details
Approval Date
10/4/2019
Contract Begin Date
1/1/2020
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
10/4/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session