340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-2069
CH10079AB La Clinica Del Valle Family Health Care Center, Inc.
Print
Covered Entity Details
Entity Name
La Clinica Del Valle Family Health Care Center, Inc.
Subdivision Name
La Clinica School-Based Health Center at Talent Elementary School
Type
HRSA-Funded Health Center
340B ID
CH10079AB
Entity Address
307 Wagner Creek Street RM 8 & 9
Talent, OR 97540-0000
Grant Number
H80CS00759
Participating Start Date
7/1/2021
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2069
Pharmacy Address
1360 CENTER DR.
MEDFORD, OR 97501
Pharmacy Comments
Contract Details
Approval Date
1/11/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Traci Fossen, Chief Quality Officer
(541) 512-3912
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/11/2024
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