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WAL-MART PHARMACY 10-5997
CH091100 VALLEY HEALTH TEAM, INC.
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Covered Entity Details
Entity Name
VALLEY HEALTH TEAM, INC.
Subdivision Name
SAN JOAQUIN HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH091100
Entity Address
21890 COLORADO AVENUE
SAN JOAQUIN, CA 93660-0737
Grant Number
H80CS00525
Participating Start Date
7/1/1999
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5997
Pharmacy Address
9600 PARKSOUTH CT. SUITE 100
ORLANDO, FL 32837
Pharmacy Comments
Contract Details
Approval Date
4/24/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
SOYLA GRIFFIN, CEO
(559) 693-2462 Ext: 2950
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/24/2017
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