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WAL-MART PHARMACY 10-3320
CH060750 NUESTRA CLINICA DEL VALLE
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Covered Entity Details
Entity Name
NUESTRA CLINICA DEL VALLE
Subdivision Name
NUESTRA CLINICA DEL VALLE, INC.
Type
HRSA-Funded Health Center
340B ID
CH060750
Entity Address
806 West 3rd Street
San Juan, TX 78589-2276
Grant Number
H80CS00209
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3320
Pharmacy Address
215 EAST MILE 3 ROAD
PALMHURST, TX 78574
Pharmacy Comments
Contract Details
Approval Date
10/13/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
LUCY TORRES, CHIEF EXECUTIVE OFFICER
(956) 787-8915 Ext: 231
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/13/2020
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