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WAL-MART PHARMACY 10-1645
CH09534G Altura Centers for Health
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Covered Entity Details
Entity Name
Altura Centers for Health
Subdivision Name
Altura Centers for Health Woodville
Type
HRSA-Funded Health Center
340B ID
CH09534G
Entity Address
16686 ROAD 168
WOODVILLE, CA 93257
Grant Number
H80CS00338
Participating Start Date
10/1/2014
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1645
Pharmacy Address
250 S 12TH AVE
HANFORD, CA 93230
Pharmacy Comments
Contract Details
Approval Date
7/1/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
GRACIELA Soto Perez, CEO
(559) 685-4601
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
7/1/2024
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