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WAL-MART PHARMACY 10-2368
FQHCLA431 VALLEY HEALTH PARTNERS COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
VALLEY HEALTH PARTNERS COMMUNITY HEALTH CENTER
Subdivision Name
Family Health Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA431
Entity Address
400 N 17th St
STE 300
Allentown, PA 18104
Grant Number
LALCS45056
Participating Start Date
1/1/2022
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2368
Pharmacy Address
355 LINCOLN AVE
EAST STROUDSBURG, PA 18301
Pharmacy Comments
Contract Details
Approval Date
1/13/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Veronica Gonzalez, Chief Executive Officer
(610) 969-2728
Contract Pharmacy Representative
Walmart
Van Donn, Director of Contracting 340b
(303) 261-5549
Signed By Date
1/13/2025
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