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BI-MART CORP.
CH101630 VALLEY FAMILY HEALTH CARE INC
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Covered Entity Details
Entity Name
VALLEY FAMILY HEALTH CARE INC
Subdivision Name
VALLEY FAMILY HEALTH CARE - Payette Medical Clinic
Type
HRSA-Funded Health Center
340B ID
CH101630
Entity Address
1441 NE 10th Ave
Payette, ID 83661-5420
Grant Number
H80CS00556
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
BI-MART CORP.
Pharmacy Address
DBA BI-MART PHARMACY #681
179 WEST HIGHWAY 52
EMMETT, ID 83617
Pharmacy Comments
Contract Details
Approval Date
10/1/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/7/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Bill Moore, Executive Director
(208) 642-9376 Ext: 4114
Contract Pharmacy Representative
Mandi Forrester, Pharm.D
(208) 272-9454
Signed By Date
10/1/2014
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