Contract Pharmacy Details

WALGREEN CO.
CH092536U JWCH INSTITUTE, INC.

Covered Entity Details

Entity Name

JWCH INSTITUTE, INC.

Subdivision Name

Wesley Health Centers (Vermont)

Type

HRSA-Funded Health Center

340B ID

CH092536U

Entity Address

954 N. Vermont Ave.
LOS ANGELES, CA 90029-3529

Grant Number

H80CS06673

Participating Start Date

1/1/2015

Last Recertification Date

2/19/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 05773
11800 ARTESIA BLVD
ARTESIA, CA 90701

Pharmacy Comments

Contract Details

Approval Date

10/17/2019

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

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

10/17/2019

340B Drug Pricing Program Database