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WAL-MART PHARMACY 10-5658
CH09071AG COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.
Subdivision Name
COMMUNITY HEALTH CENTERS ARBOR
Type
HRSA-Funded Health Center
340B ID
CH09071AG
Entity Address
1418 E MAIN ST, STE 210
SANTA MARIA, CA 93454
Grant Number
H80CS00621
Participating Start Date
4/1/2010
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5658
Pharmacy Address
2240 S BRADLEY RD
SANTA MARIA, CA 93454
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
RONALD E. CASTLE, CEO
(805) 459-1835
Contract Pharmacy Representative
Walmart
Christian Nava, Senior Manager, Program Development-340B
(210) 632-0647
Signed By Date
7/15/2024
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