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WAL-MART PHARMACY 10-1554
CH090780 Community Medical Centers, Inc.
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Covered Entity Details
Entity Name
Community Medical Centers, Inc.
Subdivision Name
Community Medical Centers, Channel
Type
HRSA-Funded Health Center
340B ID
CH090780
Entity Address
701 E Channel St.
Stockton, CA 95202-2628
Grant Number
H80CS00138
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1554
Pharmacy Address
3223 EAST HAMMER LANE
STOCKTON, CA 95212
Pharmacy Comments
Contract Details
Approval Date
3/15/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kathleen Marshall, Acting CEO
(209) 373-2826
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
1/28/2013
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