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ENTREGA PHARMACY LLC
CH092536AN JWCH Institute, Inc.
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Covered Entity Details
Entity Name
JWCH Institute, Inc.
Subdivision Name
Wesley Health Centers- Palmdale Central
Type
HRSA-Funded Health Center
340B ID
CH092536AN
Entity Address
2151 E Palmdale Blvd
Palmdale, CA 93550-4037
Grant Number
H80CS06673
Participating Start Date
5/2/2019
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
ENTREGA PHARMACY LLC
Pharmacy Address
DBA ENTREGA PHARMACY
44469 10TH ST W STE B
LANCASTER, CA 93534-3324
Pharmacy Comments
Contract Details
Approval Date
9/24/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ALVARO BALLESTEROS, EXECUTIVE DIRECTOR
(323) 201-4516 Ext: 3009
Contract Pharmacy Representative
Entrega Pharmacy
Loc Quan, President
(661) 579-2099
Signed By Date
9/24/2021
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