340B Drug Pricing Program Database
WAL-MART PHARMACY 10-5947
CH06796B PROJECT VIDA HEALTH CENTER - information as of 5/16/2025 2:01:34 AM
Covered Entity Details
Entity Name
PROJECT VIDA HEALTH CENTER
Subdivision Name
NORTHEAST FAMILY PRACTICE
Type
HRSA-Funded Health Center
340B ID
CH06796B
Entity Address
4875 MAXWELL AVE STE BE
EL PASO, TX 79904-1450
Grant Number
H80CS04287
Participating Start Date
10/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5947
Pharmacy Address
5631 DYER ST
EL PASO, TX 79904
Pharmacy Comments
Contract Details
Approval Date
10/3/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bill Schlesinger, CEO
(915) 465-1191 Ext: 207
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
10/3/2017
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