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WAL-MART PHARMACY 10-0397
HV060210 VALLEY AIDS COUNCIL
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Covered Entity Details
Entity Name
VALLEY AIDS COUNCIL
Subdivision Name
Type
Ryan White Part C
340B ID
HV060210
Entity Address
2306 Camelot Plaza Circle
HARLINGEN, TX 78550
Grant Number
H76HA00131
Participating Start Date
1/1/1998
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0397
Pharmacy Address
1200 E. JACKSON AVE.
MCALLEN (S), TX 78503
Pharmacy Comments
Contract Details
Approval Date
1/13/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/14/2025
Agreement registered in error
Contacts
Covered Entity Signing Official
Wally Cantu, Executive Director
(956) 428-2653
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/13/2020
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