340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-5192
CHC24113-08 ELICA HEALTH CENTERS
Print
Covered Entity Details
Entity Name
ELICA HEALTH CENTERS
Subdivision Name
Elica Health Centers - V Street Medical Center
Type
HRSA-Funded Health Center
340B ID
CHC24113-08
Entity Address
923 V St
Sacramento, CA 95818
Grant Number
H80CS24113
Participating Start Date
1/1/2018
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5192
Pharmacy Address
5821 ANTELOPE ROAD
SACRAMENTO, CA 95842
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David E Hughes, COO/CFO
(916) 569-8484 Ext: 312
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/16/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session