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CAPITOL DRUGS - WEST HOLLYWOOD
CH092536AM JWCH Institute, Inc.
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Covered Entity Details
Entity Name
JWCH Institute, Inc.
Subdivision Name
Wesley Health Centers- Health and Wellness Center
Type
HRSA-Funded Health Center
340B ID
CH092536AM
Entity Address
45104 10th St W
Lancaster, CA 93534-2310
Grant Number
H80CS06673
Participating Start Date
5/2/2019
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
CAPITOL DRUGS - WEST HOLLYWOOD
Pharmacy Address
8578 SANTA MONICA BLVD
WEST HOLLYWOOD, CA 90069
Pharmacy Comments
Contract Details
Approval Date
1/15/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ALVARO BALLESTEROS, EXECUTIVE DIRECTOR
(323) 201-4516 Ext: 3009
Contract Pharmacy Representative
VLS Capitol Drugs, Inc.
Raja Sannidhi, President
(310) 289-1125
Signed By Date
1/15/2024
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