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WAL-MART PHARMACY 10-5635
CH09364AD Family Healthcare Network
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Covered Entity Details
Entity Name
Family Healthcare Network
Subdivision Name
Family HealthCare Network - Surgical Consultation Center
Type
HRSA-Funded Health Center
340B ID
CH09364AD
Entity Address
255 N. Herwaldt Drive
Fresno, CA 93701
Grant Number
H80CS00786
Participating Start Date
10/1/2018
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5635
Pharmacy Address
1320 N DEMAREE ST
VISALIA, CA 93291
Pharmacy Comments
Contract Details
Approval Date
7/13/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kerry Hydash, President and CEO
(559) 737-4700
Contract Pharmacy Representative
Walmart
Van Donn, 340B Director Contracting
(479) 273-4000
Signed By Date
7/13/2024
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