340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-1834
CH100790 LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC
Print
Covered Entity Details
Entity Name
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC
Subdivision Name
PHOENIX HEALTH CENTER--LA CLINICA
Type
HRSA-Funded Health Center
340B ID
CH100790
Entity Address
3617 S Pacific Hwy
Medford, OR 97501-8957
Grant Number
H80CS00759
Participating Start Date
1/1/1999
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1834
Pharmacy Address
135 NE TERRY LANE
GRANTS PASS, OR 97526
Pharmacy Comments
Contract Details
Approval Date
10/3/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Traci Fossen, Chief Quality Officer
(541) 512-3912
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/3/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session