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WAL-MART CENTRAL FILL 10-2670
CH091880 BAY CLINIC, INC.
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Covered Entity Details
Entity Name
BAY CLINIC, INC.
Subdivision Name
Hilo Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH091880
Entity Address
1178 Kinoole Street
Bldg. B
Hilo, HI 96720
Grant Number
H80CS00837
Participating Start Date
10/1/2004
Last Recertification Date
2/23/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
WAL-MART CENTRAL FILL 10-2670
Pharmacy Address
608 SPRING HILL DR # 3 SUITE 300
SPRING, TX 77386
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Christian Kimo Alameda, Chief Executive Officer
(808) 930-4083
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/15/2019
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