Contract Pharmacy Details

WAL-MART PHARMACY 10-1700
CH091670 VISTA COMMUNITY CLINIC

Covered Entity Details

Entity Name

VISTA COMMUNITY CLINIC

Subdivision Name

VCC: VALE TERRACE

Type

HRSA-Funded Health Center

340B ID

CH091670

Entity Address

1000 Vale Terrace Dr.
Vista, CA 92084-5218

Grant Number

H80CS00282

Participating Start Date

4/1/1996

Last Recertification Date

2/19/2025

Pharmacy Details

Pharmacy Name

WAL-MART PHARMACY 10-1700

Pharmacy Address

13425 COMMUNITY ROAD
POWAY, CA 92064

Pharmacy Comments

Contract Details

Approval Date

4/5/2022

Contract Begin Date

7/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Michele Lambert, CFO
(760) 216-5803

Contract Pharmacy Representative

Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498

Signed By Date

4/5/2022

340B Drug Pricing Program Database