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RALEY'S PHARMACY #340
CH093210 Camarena Health
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Covered Entity Details
Entity Name
Camarena Health
Subdivision Name
DMC WOMEN'S CARE HEALTH CTR
Type
HRSA-Funded Health Center
340B ID
CH093210
Entity Address
201 S B St
Madera, CA 93638-3719
Grant Number
H80CS00143
Participating Start Date
4/1/2001
Last Recertification Date
1/31/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
RALEY'S PHARMACY #340
Pharmacy Address
40041 HIGHWAY 49
OAKHURST, CA 93644
Pharmacy Comments
Contract Details
Approval Date
9/12/2012
Contract Begin Date
9/12/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Paulo A. Soares, CEO
(559) 664-4089
Contract Pharmacy Representative
Raley's
Flint Pendergraft, Vice President, Pharmacy & Healthy Lifestyle Initiatives
(916) 373-6146
Signed By Date
9/5/2012
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