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WAL-MART PHARMACY 10-1983
CH09047AC GOLDEN VALLEY HEALTH CENTERS
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Covered Entity Details
Entity Name
GOLDEN VALLEY HEALTH CENTERS
Subdivision Name
GVHC - CERES EAST
Type
HRSA-Funded Health Center
340B ID
CH09047AC
Entity Address
1920 MEMORIAL DR
CERES, CA 95307-1827
Grant Number
H80CS00742
Participating Start Date
4/1/2017
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1983
Pharmacy Address
3960 MITCHELL RD
CERES, CA 95307
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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