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WAL-MART CENTRAL FILL 10-2670
CH0910140 COMMUNITY HEALTH ALLIANCE OF PASADENA
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Covered Entity Details
Entity Name
COMMUNITY HEALTH ALLIANCE OF PASADENA
Subdivision Name
COMMUNITY HEALTH ALLIANCE OF PASADENA
Type
HRSA-Funded Health Center
340B ID
CH0910140
Entity Address
1855 N Fair Oaks Ave
Pasadena, CA 91103-1620
Grant Number
H80CS04220
Participating Start Date
1/1/2004
Last Recertification Date
2/2/2023
Entity Termination Date
4/1/2024
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
7/6/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
MARGARET B. MARTINEZ, Chief Executive Officer
(626) 993-1227
Contract Pharmacy Representative
Wellpartner
Emma Eddy, Sr. Consultant
(480) 204-0069
Signed By Date
7/6/2020
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