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BOTICA DEL SOL
CH092536AE JWCH Institute, Inc.
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Covered Entity Details
Entity Name
JWCH Institute, Inc.
Subdivision Name
JWCH Institute, Inc., Mini House Residential Treatment
Type
HRSA-Funded Health Center
340B ID
CH092536AE
Entity Address
303 E 52nd St
Los Angeles, CA 90011-4513
Grant Number
H80CS06673
Participating Start Date
7/1/2018
Last Recertification Date
2/23/2025
Pharmacy Details
Pharmacy Name
BOTICA DEL SOL
Pharmacy Address
HYGEIA APOTHECARY, INC. DBA
2331 CESAR CHAVEZ AVENUE
LOS ANGELES, CA 90033
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
11/4/2020
Agreement registered in error
Contacts
Covered Entity Signing Official
ALVARO BALLESTEROS, EXECUTIVE DIRECTOR
(323) 201-4516 Ext: 3009
Contract Pharmacy Representative
Botica Del Sol
Yousef Bahdi, Owner
(323) 260-7531
Signed By Date
10/15/2020
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