Contract Pharmacy Details

WAL-MART PHARMACY 10-3276
CHC28985-06 CENTRAL NEIGHBORHOOD HEALTH FOUNDATION

Covered Entity Details

Entity Name

CENTRAL NEIGHBORHOOD HEALTH FOUNDATION

Subdivision Name

Central Neighborhood Health Foundation H Street Clinic

Type

HRSA-Funded Health Center

340B ID

CHC28985-06

Entity Address

1329 N H ST
SAN BERNARDINO, CA 92405-5039

Grant Number

H80CS28985

Participating Start Date

7/1/2018

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

WAL-MART PHARMACY 10-3276

Pharmacy Address

4001 HALLMARK PKWY
SAN BERNARDINO (N), CA 92407

Pharmacy Comments

Contract Details

Approval Date

10/16/2019

Contract Begin Date

1/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/3/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Kenneth Orduna, CEO
(323) 547-1402

Contract Pharmacy Representative

Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498

Signed By Date

10/16/2019

340B Drug Pricing Program Database