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WAL-MART PHARMACY 10-2495
CHC10608-00 CENTRAL CITY COMMUNITY HEALTH CENTER, INC
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Covered Entity Details
Entity Name
CENTRAL CITY COMMUNITY HEALTH CENTER, INC
Subdivision Name
Central City Community Health Center, Inc. - Anaheim
Type
HRSA-Funded Health Center
340B ID
CHC10608-00
Entity Address
2237 W.Ball Road
Anaheim, CA 92804-5314
Grant Number
H80CS10608
Participating Start Date
7/1/2024
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2495
Pharmacy Address
13331 BEACH BLVD
WESTMINSTER, CA 92683
Pharmacy Comments
Contract Details
Approval Date
1/18/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Sommer R Kaskowitz, Chief Nursing Officer
(323) 724-0019 Ext: 1026
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/18/2022
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