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WAL-MART PHARMACY 10-1612
CH093590 UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.
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Covered Entity Details
Entity Name
UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.
Subdivision Name
CONTINENTAL FAMILY MEDICAL CTR
Type
HRSA-Funded Health Center
340B ID
CH093590
Entity Address
1260 S. CAMPBELL RD
BLDG 1
GREEN VALLEY, AZ 85614
Grant Number
H80CS00416
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1612
Pharmacy Address
1650 WEST VALENCIA
TUCSON, AZ 85746
Pharmacy Comments
Contract Details
Approval Date
1/9/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tamie Olson, Chief Financial Officer
(520) 407-5600
Contract Pharmacy Representative
Walmart
Nick Tallman, Sr. Director, Merchandise Operations – Pharmacy
(479) 371-0417
Signed By Date
1/9/2025
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