Contract Pharmacy Details

WAL-MART PHARMACY 10-2190
CH092420 OLE HEALTH

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 10-2190

Pharmacy Address

1720 EAST MAIN STREET
WOODLAND, CA 95776

Pharmacy Comments

Contract Details

Approval Date

7/17/2023

Contract Begin Date

10/1/2023

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
Van Donn, Director of Contracting 340b
(303) 261-5549

Signed By Date

7/17/2023

340B Drug Pricing Program Database