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LOS ANGELES COUNTY HEALTH SERVICES CENTRAL PHARMACY
CH092536AC JWCH INSTITUTE, INC.
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Covered Entity Details
Entity Name
JWCH INSTITUTE, INC.
Subdivision Name
Wesley Health Center -- Hacienda Heights
Type
HRSA-Funded Health Center
340B ID
CH092536AC
Entity Address
15898 GALE AVE
HACIENDA HEIGHTS, CA 91745-1601
Grant Number
H80CS06673
Participating Start Date
7/1/2016
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
LOS ANGELES COUNTY HEALTH SERVICES CENTRAL PHARMACY
Pharmacy Address
313 N FIGUEROA STREET
SUITE 1225
LOS ANGELES, CA 90012
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2019
Agreement registered in error
Contacts
Covered Entity Signing Official
ALVARO BALLESTEROS, EXECUTIVE DIRECTOR
(323) 201-4516 Ext: 3009
Contract Pharmacy Representative
County of Los Angeles
Shane D'Souza, Pharmacy Services Chief II
(213) 240-7717
Signed By Date
1/12/2018
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