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WAL-MART PHARMACY 10-1692
CHC28988-00 DAP HEALTH INC
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Covered Entity Details
Entity Name
DAP HEALTH INC
Subdivision Name
Desert AIDS Project, Inc.
Type
HRSA-Funded Health Center
340B ID
CHC28988-00
Entity Address
1695 N Sunrise Way
Palm Springs, CA 92262-3701
Grant Number
H80CS28988
Participating Start Date
4/1/2016
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1692
Pharmacy Address
1120 SOUTH MT VERNON AVE
COLTON, CA 92324
Pharmacy Comments
Contract Details
Approval Date
7/6/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Brinkman, Chief Executive Officer
(760) 992-0418
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
7/6/2023
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