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PRIME THERAPEUTICS SPECIALTY PHARMACY LL
CH091100 VALLEY HEALTH TEAM, INC.
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Covered Entity Details
Entity Name
VALLEY HEALTH TEAM, INC.
Subdivision Name
SAN JOAQUIN HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH091100
Entity Address
21890 COLORADO AVENUE
SAN JOAQUIN, CA 93660-0737
Grant Number
H80CS00525
Participating Start Date
7/1/1999
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
PRIME THERAPEUTICS SPECIALTY PHARMACY LL
Pharmacy Address
ALLIANCERX WALGREENS PRIME #16568
2354 COMMERCE PARK DRIVE
SUITE 100
ORLANDO, FL 32819-9992
Pharmacy Comments
Contract Details
Approval Date
4/11/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/31/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Soyla Griffin, Chief Executive Officer
(559) 693-2462 Ext: 2943
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/11/2022
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