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WAL-MART PHARMACY 10-5078
CH101340 YAKIMA NEIGHBORHOOD HEALTH SERVICES
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Covered Entity Details
Entity Name
YAKIMA NEIGHBORHOOD HEALTH SERVICES
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH101340
Entity Address
12 SOUTH 8TH STREET
YAKIMA, WA 98901
Grant Number
H80CS06078
Participating Start Date
4/1/1999
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5078
Pharmacy Address
6600 W NOB HILL BLVD
YAKIMA, WA 98908
Pharmacy Comments
Contract Details
Approval Date
7/19/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ANITA MONOIAN, CEO
(509) 574-5550
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
7/19/2017
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