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WAL-MART PHARMACY 10-1979
CH092420 OLE HEALTH
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Covered Entity Details
Entity Name
OLE HEALTH
Subdivision Name
OLE Health - North Napa Campus
Type
HRSA-Funded Health Center
340B ID
CH092420
Entity Address
1141 PEAR TREE LANE
Suite 100
NAPA, CA 94558-6485
Grant Number
H80CS04219
Participating Start Date
10/1/2004
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1979
Pharmacy Address
15960 DAM ROAD
CLEARLAKE, CA 95422
Pharmacy Comments
Contract Details
Approval Date
4/12/2023
Contract Begin Date
5/17/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin E. Moses, Legal Officer
(707) 254-1774 Ext: 8222
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/12/2023
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