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WALNUT PHARMACY LLC
CH09534J Altura Centers for Health
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Covered Entity Details
Entity Name
Altura Centers for Health
Subdivision Name
Altura Centers for Health Mobile Clinic 2
Type
HRSA-Funded Health Center
340B ID
CH09534J
Entity Address
1134 E Cartmill Avenue
TULARE, CA 93274-9615
Grant Number
H80CS00338
Participating Start Date
10/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALNUT PHARMACY LLC
Pharmacy Address
10331 W GOSHEN AVE UNIT B
VISALIA, CA 93291
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
Walnut Pharmacy
Chandra Sekhar Panchumarthi, Pharmacist
(919) 986-0153
Signed By Date
7/1/2024
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