Contract Pharmacy Details

GARFIELD BEACH CVS, L.L.C.
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

GARFIELD BEACH CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09732
861 NORTH VINE STREET
HOLLYWOOD, CA 90038

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

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

Signed By Date

7/14/2020

340B Drug Pricing Program Database