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PORTERVILLE PHARMACY
CHC08739-00 Aria Community Health Center
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Covered Entity Details
Entity Name
Aria Community Health Center
Subdivision Name
AVENAL COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CHC08739-00
Entity Address
1000 Skyline Blvd Ste A
Avenal, CA 93204-1850
Grant Number
H80CS08739
Participating Start Date
7/1/2009
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
PORTERVILLE PHARMACY
Pharmacy Address
406 W PUTNAM AVE
PORTERVILLE, CA 93257
Pharmacy Comments
Contract Details
Approval Date
4/4/2019
Contract Begin Date
4/4/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John Blaine, CEO
(559) 386-4500 Ext: 1010
Contract Pharmacy Representative
Porterville Pharmacy
John Mikhael, Manager
(559) 615-1560
Signed By Date
4/4/2019
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