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LA FAMILIA PHARMACY
CH092536Y JWCH INSTITUTE, INC.
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Covered Entity Details
Entity Name
JWCH INSTITUTE, INC.
Subdivision Name
NORWALK REGIONAL HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH092536Y
Entity Address
12360 FIRESTONE BLVD
NORWALK, CA 90650-4324
Grant Number
H80CS06673
Participating Start Date
1/1/2015
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
LA FAMILIA PHARMACY
Pharmacy Address
14359 PIONEER BLVD
STE B
NORWALK, CA 90650-4870
Pharmacy Comments
Contract Details
Approval Date
7/14/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ALVARO BALLESTEROS, EXECUTIVE DIRECTOR
(323) 201-4516 Ext: 3009
Contract Pharmacy Representative
La Familia Pharmacy
Amit Hasolkar, Pharmacist
(562) 868-2277
Signed By Date
7/14/2020
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