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SHAVANO PHARMACY LLC
CH080030 VALLEY-WIDE HEALTH SYSTEMS, INC.
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Covered Entity Details
Entity Name
VALLEY-WIDE HEALTH SYSTEMS, INC.
Subdivision Name
Alamosa Family Medical Center, Valley Wide Pharmacy, or Anti-Coagulation Clinic
Type
HRSA-Funded Health Center
340B ID
CH080030
Entity Address
1710 1st St
Alamosa, CO 81101
Grant Number
H80CS00134
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
SHAVANO PHARMACY LLC
Pharmacy Address
415 US HIGHWAY 24 N
BUENA VISTA, CO 81211-9651
Pharmacy Comments
Contract Details
Approval Date
1/7/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/27/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jania Arnoldi, President/CEO
(719) 587-1000
Contract Pharmacy Representative
Shavano Pharmacy LLC
Rebecca Seaman, Owner
(719) 398-6550
Signed By Date
1/7/2021
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