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ONE CARE PHARMACY, LLC
FQHCLA465 GALLUP COMMUNITY HEALTH
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Covered Entity Details
Entity Name
GALLUP COMMUNITY HEALTH
Subdivision Name
Gallup Community Health - 2022
Type
Health Center Program Look-Alike
340B ID
FQHCLA465
Entity Address
2111 College Dr
Gallup, NM 87301-4804
Grant Number
LALCS52988
Participating Start Date
7/1/2024
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
ONE CARE PHARMACY, LLC
Pharmacy Address
DBA: ONE CARE PHARMACY
2111 COLLEGE DR UNIT 3
GALLUP, NM 87301
Pharmacy Comments
Contract Details
Approval Date
1/8/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Valory Wangler, MD
(206) 861-5767
Contract Pharmacy Representative
One Care Infusion Pharmacy
Mohannad Rashid, Owner
(505) 726-4155
Signed By Date
1/8/2025
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