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WALMART PHARMACY 10-7361
STD78550 Valley AIDS Council
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Covered Entity Details
Entity Name
Valley AIDS Council
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD78550
Entity Address
2306 Camelot Plaza Circle
Harlingen, TX 78550-8407
Grant Number
NU62PS924529
Participating Start Date
1/1/2017
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-7361
Pharmacy Address
12631 BROADWAY ST.
PEARLAND, TX 77584
Pharmacy Comments
Contract Details
Approval Date
1/14/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Wally Cantu, Executive Director
(956) 428-2653
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/14/2025
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