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WAL-MART PHARMACY 10-5843
CH09047AG Golden Valley Health Centers
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Covered Entity Details
Entity Name
Golden Valley Health Centers
Subdivision Name
GVHC - TURLOCK PEDIATRIC HEALTH CENTER 1100
Type
HRSA-Funded Health Center
340B ID
CH09047AG
Entity Address
1100 Delbon Ave
Turlock, CA 95382-2021
Grant Number
H80CS00742
Participating Start Date
7/1/2018
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5843
Pharmacy Address
1030 SPERRY AVE
PATTERSON, CA 95363
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
Gurjeet Sandhu, Vice President and Chief Financial Officer
(209) 384-6516
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
10/16/2023
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