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Walmart Pharmacy 10-7611
CH095320 VALLEY COMMUNITY HEALTHCARE
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Covered Entity Details
Entity Name
VALLEY COMMUNITY HEALTHCARE
Subdivision Name
VALLEY COMMUNITY HEALTHCARE
Type
HRSA-Funded Health Center
340B ID
CH095320
Entity Address
6801 Coldwater Canyon Ave
North Hollywood, CA 91605-5162
Grant Number
H80CS04222
Participating Start Date
11/17/2005
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
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
Paula Wilson, CEO
(818) 301-6333
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/16/2023
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