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THE MEDICINE CABINET #3
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
THE MEDICINE CABINET #3
Pharmacy Address
3270 TWEEDY BLVD STE C
SOUTH GATE, CA 90280
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
The Medicine Cabinet
Ash Soliman, Director
(562) 806-8394
Signed By Date
10/15/2020
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