Contract Pharmacy Details

THE MEDICINE CABINET #1
CH0925360 JWCH INSTITUTE, INC.

Covered Entity Details

Entity Name

JWCH INSTITUTE, INC.

Subdivision Name

JWCH Institute Corporate Headquarters

Type

HRSA-Funded Health Center

340B ID

CH0925360

Entity Address

5650 JILLSON ST
COMMERCE, CA 90040-1482

Grant Number

H80CS06673

Participating Start Date

9/16/2005

Last Recertification Date

2/19/2025

Pharmacy Details

Pharmacy Name

THE MEDICINE CABINET #1

Pharmacy Address

7119 RITA AVE STE G
HUNTINGTON PARK, CA 90255-4786

Pharmacy Comments

Contract Details

Approval Date

10/15/2020

Contract Begin Date

1/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/1/2023
Business decision by covered entity and/or pharmacy

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

340B Drug Pricing Program Database