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COUNTY OF LOS ANGELES - AUDITOR CONTROLL
CH091037X St. John's Well Child And Family Center, Inc.
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Covered Entity Details
Entity Name
St. John's Well Child And Family Center, Inc.
Subdivision Name
SJWCFC - Avalon Health and Access Center
Type
HRSA-Funded Health Center
340B ID
CH091037X
Entity Address
6818 Avalon Blvd
Los Angeles, CA 90003-1922
Grant Number
H80CS00873
Participating Start Date
7/1/2021
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
COUNTY OF LOS ANGELES - AUDITOR CONTROLL
Pharmacy Address
313 N FIGUEROA ST STE 1225
HEALTH SERVICES CENTRAL PHARMACY
LOS ANGELES, CA 90012-2602
Pharmacy Comments
Contract Details
Approval Date
7/7/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/3/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
James Mangia, CEO
(323) 541-1600 Ext: 4000
Contract Pharmacy Representative
LA County DHS
Rabeah Elbanna, Pharmacy Supervisor I
(213) 288-7717
Signed By Date
7/7/2021
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