340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALMART PHARMACY 10-5169
CH091750 MOUNTAIN VALLEYS HEALTH CENTERS
Print
Covered Entity Details
Entity Name
MOUNTAIN VALLEYS HEALTH CENTERS
Subdivision Name
BIG VALLEY MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH091750
Entity Address
554-850 MEDICAL CENTER DRIVE
BIEBER, CA 96009-0277
Grant Number
H80CS00260
Participating Start Date
4/1/2000
Last Recertification Date
2/17/2025
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
1/16/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shannon Gerig, CEO
(530) 999-9010
Contract Pharmacy Representative
Walmart
Van Donn, 340B Director Contracting
(999) 999-9999
Signed By Date
1/16/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session