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WAL-MART PHARMACY 10-2989
CH093190 TIBURCIO VASQUEZ HEALTH CENTER INCORPORATED
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Covered Entity Details
Entity Name
TIBURCIO VASQUEZ HEALTH CENTER INCORPORATED
Subdivision Name
TIBURCIO VASQUEZ HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH093190
Entity Address
33255 9th St
Union City, CA 94587-2137
Grant Number
H80CS00223
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2989
Pharmacy Address
44009 OSGOOD ROAD
FREMONT, CA 94539
Pharmacy Comments
Contract Details
Approval Date
10/21/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Andrea Schwab Galindo, Chief Executive Officer
(510) 460-3855
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/21/2024
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