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WALMART PHARMACY 10-5169
CHC33795-01 Monterey, County Of
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Covered Entity Details
Entity Name
Monterey, County Of
Subdivision Name
Monterey County Clinic at Marina
Type
HRSA-Funded Health Center
340B ID
CHC33795-01
Entity Address
3155 De Forest Rd
Marina, CA 93933-2702
Grant Number
H80CS33795
Participating Start Date
1/1/2020
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
Pharmacy Comments
Contract Details
Approval Date
1/12/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Prashant Shinde, Bureau Chief
(831) 796-1370
Contract Pharmacy Representative
Walmart
Craig Smith, RPh.
(479) 903-5739
Signed By Date
1/12/2023
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