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WAL-MART PHARMACY 10-5701
CH09056W United Health Centers of The San Joaquin Valley
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Covered Entity Details
Entity Name
United Health Centers of The San Joaquin Valley
Subdivision Name
United Health Centers - Parlier Manning
Type
HRSA-Funded Health Center
340B ID
CH09056W
Entity Address
429 E Manning Ave
Parlier, CA 93648-2600
Grant Number
H80CS00137
Participating Start Date
7/6/2020
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5701
Pharmacy Address
14061 W WHITESBRIDGE AVE
KERMAN, CA 93630
Pharmacy Comments
Contract Details
Approval Date
10/11/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Navjot Singh, Contracting & Managed Care Officer
(559) 646-6618 Ext: 0039
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
10/11/2022
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