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WAL-MART PHARMACY 10-5315
CH09056W United Health Centers of The San Joaquin Valley
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Covered Entity Details
Entity Name
United Health Centers of The San Joaquin Valley
Subdivision Name
United Health Centers - Parlier Manning
Type
HRSA-Funded Health Center
340B ID
CH09056W
Entity Address
429 E Manning Ave
Parlier, CA 93648-2600
Grant Number
H80CS00137
Participating Start Date
7/6/2020
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5315
Pharmacy Address
2354 COMMERCE PARK DR.
ORLANDO, FL 32819
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/3/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Navjot Singh, Contracting & Managed Care Officer
(559) 646-6618 Ext: 0039
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/16/2023
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