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WAL-MART PHARMACY 10-5603
CHC12858-00 FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, INC.
Subdivision Name
Bell Gardens Family Medical Center
Type
HRSA-Funded Health Center
340B ID
CHC12858-00
Entity Address
6501 Garfield Ave.
A
Bell Gardens, CA 90201-1805
Grant Number
H80CS12858
Participating Start Date
9/9/2005
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5603
Pharmacy Address
12270 PARAMOUNT BLVD
DOWNEY, CA 90242
Pharmacy Comments
Contract Details
Approval Date
10/10/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Raquel R. Villa, Chief Executive Officer
(562) 776-5014
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/10/2018
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