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WAL-MART PHARMACY 10-5394
CH090560 UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
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Covered Entity Details
Entity Name
UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
Subdivision Name
UNITED HEALTH CENTERS PARLIER
Type
HRSA-Funded Health Center
340B ID
CH090560
Entity Address
650 S Zediker Ave
Parlier, CA 93648-2639
Grant Number
H80CS00137
Participating Start Date
12/1/1992
Last Recertification Date
2/24/2021
Entity Termination Date
4/1/2023
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5394
Pharmacy Address
770 WEST EL MONTE WAY
DINUBA, CA 93618
Pharmacy Comments
Contract Details
Approval Date
7/7/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/2/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
COLLEEN CURTIS, CEO
(559) 646-6618 Ext: 0007
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
7/7/2014
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