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GARFIELD BEACH CVS, L.L.C.
CH092536AF JWCH Institute, Inc.
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Covered Entity Details
Entity Name
JWCH Institute, Inc.
Subdivision Name
Wesley Health Centers -- Lynwood High School
Type
HRSA-Funded Health Center
340B ID
CH092536AF
Entity Address
12124 Bullis Rd
Ste B104
Lynwood, CA 90262-5106
Grant Number
H80CS06673
Participating Start Date
7/1/2018
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09123
3800 MARTIN LUTHER KING JR. BOULEVARD
LYNWOOD, CA 90262
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
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
10/15/2020
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