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WALMART PHARMACY 10-4127
FQHC638012G Northern Valley Indian Health
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Covered Entity Details
Entity Name
Northern Valley Indian Health
Subdivision Name
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638012G
Entity Address
1990 Concord Ave
Chico, CA 95928
Grant Number
Participating Start Date
10/1/2022
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-4127
Pharmacy Address
215 CALIFORNIA ST.
WOODLAND, CA 95695
Pharmacy Comments
Contract Details
Approval Date
7/11/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Inder Wadhwa, CEO
(530) 896-9409
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/11/2024
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