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VALLEY MEDICAL PHARMACY
CH09025G CLINICAS DE SALUD DEL PUEBLO INC
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Covered Entity Details
Entity Name
CLINICAS DE SALUD DEL PUEBLO INC
Subdivision Name
Innercare Niland
Type
HRSA-Funded Health Center
340B ID
CH09025G
Entity Address
8027 HIGHWAY 111
NILAND, CA 92257-0000
Grant Number
H80CS00733
Participating Start Date
7/1/2004
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
VALLEY MEDICAL PHARMACY
Pharmacy Address
630 MAIN ST
BRAWLEY, CA 92227-2548
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
YVONNE BELL, CEO
(760) 344-9951 Ext: 10102
Contract Pharmacy Representative
Valley Medical Pharmacy
Dan Vithalani, President & CEO
(760) 344-6303
Signed By Date
10/13/2023
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