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WAL-MART PHARMACY 10-5215
CH09364M FAMILY HEALTHCARE NETWORK
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Covered Entity Details
Entity Name
FAMILY HEALTHCARE NETWORK
Subdivision Name
Family HealthCare Network - Terra Bella Health Center
Type
HRSA-Funded Health Center
340B ID
CH09364M
Entity Address
9416 Road 238
Terra Bella, CA 93270-9400
Grant Number
H80CS00786
Participating Start Date
4/1/2014
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5215
Pharmacy Address
530 WOOLLOMES AVE
DELANO, CA 93215
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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