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ALAMOSA PHARMACY
CH080030 VALLEY-WIDE HEALTH SYSTEMS, INC.
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Covered Entity Details
Entity Name
VALLEY-WIDE HEALTH SYSTEMS, INC.
Subdivision Name
Alamosa Family Medical Center, Valley Wide Pharmacy, or Anti-Coagulation Clinic
Type
HRSA-Funded Health Center
340B ID
CH080030
Entity Address
1710 1st St
Alamosa, CO 81101
Grant Number
H80CS00134
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
ALAMOSA PHARMACY
Pharmacy Address
POLITO E MARTINEZ JR, RPH
108 BLANCA AVENUE
SAN LUIS VALLEY REG MEDICAL CTR
ALAMOSA, CO 81101
Pharmacy Comments
Contract Details
Approval Date
10/1/2012
Contract Begin Date
10/1/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/21/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jeanne Darricades, CEO
(719) 589-5161
Contract Pharmacy Representative
Joseph T. Valdez, Owner/Partner
(719) 274-5109
Signed By Date
9/6/2012
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