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WALMART PHARMACY 10-5169
FQHCLA048 County of Tulare
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Covered Entity Details
Entity Name
County of Tulare
Subdivision Name
Tulare County Health Services
Type
Health Center Program Look-Alike
340B ID
FQHCLA048
Entity Address
5957 S. Mooney Blvd
Visalia, CA 93277
Grant Number
LALCS00070
Participating Start Date
7/1/1996
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
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
Karen M Elliott, Director of Public Health
(559) 624-8481
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/2/2023
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