340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-2052
CH09194A MENDOCINO COMMUNITY HEALTH CLINIC, INC.
Print
Covered Entity Details
Entity Name
MENDOCINO COMMUNITY HEALTH CLINIC, INC.
Subdivision Name
LITTLE LAKE HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH09194A
Entity Address
45 Hazel St
Willits, CA 95490-4222
Grant Number
H80CS00628
Participating Start Date
4/1/2011
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2052
Pharmacy Address
1155 AIRPORT PARK BLVD.
UKIAH, CA 95482
Pharmacy Comments
Contract Details
Approval Date
10/24/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rod Grainger, CEO
(707) 472-4667
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/24/2023
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