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WAL-MART PHARMACY 10-5701
CH09056E UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
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Covered Entity Details
Entity Name
UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
Subdivision Name
UNITED HEALTH CENTERS KERMAN
Type
HRSA-Funded Health Center
340B ID
CH09056E
Entity Address
517 S Madera Ave
Kerman, CA 93630-1523
Grant Number
H80CS00137
Participating Start Date
4/1/2004
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5701
Pharmacy Address
14061 W WHITESBRIDGE AVE
KERMAN, CA 93630
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
Navjot Singh, Contracting & Managed Care Officer
(559) 646-6618 Ext: 0039
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/15/2024
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