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Walmart Pharmacy 10-7611
CHC26623-04 OPERATION SAMAHAN
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Covered Entity Details
Entity Name
OPERATION SAMAHAN
Subdivision Name
Granger School based Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26623-04
Entity Address
2101 Granger Ave STE 101A
National City, CA 91950-6208
Grant Number
H80CS26623
Participating Start Date
4/1/2014
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/2/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
archie p bella, executive director
(844) 200-2426 Ext: 1063
Contract Pharmacy Representative
PharmaForce
Janet Salmon, Senior Relationship Manager, Western Region
(484) 861-3986
Signed By Date
10/2/2023
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