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THE MEDICINE CABINET #1
CH092536X JWCH INSTITUTE, INC.
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Covered Entity Details
Entity Name
JWCH INSTITUTE, INC.
Subdivision Name
JWCH Medical Clinic - Lynwood
Type
HRSA-Funded Health Center
340B ID
CH092536X
Entity Address
3591 E Imperial Hwy
Lynwood, CA 90262-2684
Grant Number
H80CS06673
Participating Start Date
1/1/2015
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
Long's Drugs
Ashley Ellis, Corporate Counsel
(803) 254-5884 Ext: 42309
Signed By Date
10/15/2020
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