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WAL-MART CENTRAL FILL 10-2670
CH0923660 EL DORADO COUNTY COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
EL DORADO COUNTY COMMUNITY HEALTH CENTER
Subdivision Name
EL DORADO COUNTY COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH0923660
Entity Address
4212 Missouri Flat Road
Placerville, CA 95667-6269
Grant Number
H80CS06671
Participating Start Date
1/1/2007
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WAL-MART CENTRAL FILL 10-2670
Pharmacy Address
608 SPRING HILL DR # 3 SUITE 300
SPRING, TX 77386
Pharmacy Comments
Contract Details
Approval Date
7/17/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Judy Stein, CFO
(530) 748-2327
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/17/2017
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