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Walmart Pharmacy 10-7611
CH067960 PROJECT VIDA HEALTH CENTER
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Covered Entity Details
Entity Name
PROJECT VIDA HEALTH CENTER
Subdivision Name
PROJECT VIDA HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH067960
Entity Address
3607 Rivera
EL PASO, TX 79905-2415
Grant Number
H80CS04287
Participating Start Date
10/1/2004
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
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bill Schlesinger, CEO
(915) 465-1191 Ext: 207
Contract Pharmacy Representative
Walmart
Van Donn, Director of Contracting 340b
(303) 261-5549
Signed By Date
10/12/2023
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