340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-2119
CHC02325-00 INDIAN HEALTH CENTER OF SANTA CLARA VALLEY
Print
Covered Entity Details
Entity Name
INDIAN HEALTH CENTER OF SANTA CLARA VALLEY
Subdivision Name
INDIAN HEALTH CENTER OF SANTA CLARA
Type
HRSA-Funded Health Center
340B ID
CHC02325-00
Entity Address
1333 Meridian Ave
San Jose, CA 95125-5212
Grant Number
H80CS02325
Participating Start Date
4/1/2013
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2119
Pharmacy Address
301 RANCH DR
MILPITAS, CA 95035
Pharmacy Comments
Contract Details
Approval Date
10/18/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sonya Tetnowski, CEO
(408) 445-3400 Ext: 5000
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/18/2023
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