Pharmacy Details

WAL-MART PHARMACY 10-1616 - information as of 5/13/2025 2:55:12 AM

Name
WAL-MART PHARMACY 10-1616

Address

2900 MAIN STREET
SUSANVILLE, CA 96130

Comments

Contracts
History

Contracts

Contract Detail	340B ID	Entity Name	Sub Name	Entity Type	Address	Address Cont.	City	State	Begin Date	Term Date	Edit Date
Details	CAH051320-00	BANNER LASSEN MEDICAL CENTER		Critical Access Hospital	1800 SPRING RIDGE DRIVE		SUSANVILLE	CA	04/01/2013	03/18/2016	3/18/2016 4:38 PM
Details	CH091960	NORTHEASTERN RURAL HEALTH CLINICS, INC.	NORTHEASTERN HEALTH CENTER	HRSA-Funded Health Center	1850 SPRING RIDGE DRIVE		SUSANVILLE	CA	10/19/2012		3/28/2013 3:11 PM
Details	DSH290001	RENOWN REGIONAL MEDICAL CENTER		Disproportionate Share Hospital	1155 MILL STREET		RENO	NV	01/01/2019		1/17/2023 11:40 AM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Pharmacy Address	Insert			WAL-MART PHARMACY 10-1616 2900 MAIN STREET SUSANVILLE, CA 96130	9/29/2017 6:44 AM
Details	Comments	Update				3/28/2013 4:34 PM
Addresses	Pharmacy Address	Update		Wal-Mart Pharmacy 1616 2900 MAIN ST SUSANVILLE, CA 96130	WAL-MART PHARMACY 10-1616 2900 MAIN STREET SUSANVILLE, CA 96130	10/19/2012 4:50 PM
Details	Name	Update		Wal-Mart Pharmacy 1616	WAL-MART PHARMACY 10-1616	10/19/2012 4:50 PM
Details	Comments	Insert				5/29/2012 12:18 PM
Details	Is Deleted	Insert			False	5/29/2012 12:18 PM
Addresses	Pharmacy Address	Insert			Wal-Mart Pharmacy 1616 2900 MAIN ST SUSANVILLE, CA 96130	5/29/2012 12:18 PM
Details	Name	Insert			Wal-Mart Pharmacy 1616	5/29/2012 12:18 PM