Contract Pharmacy Details

Walmart Pharmacy 10-7611
CH093210 Camarena Health

Covered Entity Details

Entity Name

Camarena Health

Subdivision Name

DMC WOMEN'S CARE HEALTH CTR

Type

HRSA-Funded Health Center

340B ID

CH093210

Entity Address

201 S B St
Madera, CA 93638-3719

Grant Number

H80CS00143

Participating Start Date

4/1/2001

Last Recertification Date

1/31/2023

Entity Termination Date

1/1/2024

Pharmacy Details

Pharmacy Name

Walmart Pharmacy 10-7611

Pharmacy Address

2501 Perry Rd
Plainfield, IN 46168

Pharmacy Comments

Contract Details

Approval Date

10/5/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Paulo A. Soares, CEO
(559) 664-4089

Contract Pharmacy Representative

Walmart
Julie Howard, 340B Program Manager
(479) 277-1498

Signed By Date

10/5/2023