340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SAVE MART PHARMACY #73
DSH050196 Central Valley General Hospital
Print
Covered Entity Details
Entity Name
Central Valley General Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050196
Entity Address
1025 N. Douty Street
Hanford, CA 93230
Medicare Provider Number
050196
Participating Start Date
1/1/2008
Last Recertification Date
8/17/2016
Entity Termination Date
10/1/2016
Pharmacy Details
Pharmacy Name
SAVE MART PHARMACY #73
Pharmacy Address
105 W HANFORD-ARMONA ROAD
LEMOORE, CA 93245
Pharmacy Comments
Contract Details
Approval Date
10/15/2012
Contract Begin Date
10/15/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2016
Contacts
Covered Entity Signing Official
David L. Larsen, SR VP CFO
(559) 537-0050
Contract Pharmacy Representative
Robert Vaughan, Senior Director of Pharmacy Operations
(209) 574-6220
Signed By Date
9/17/2012
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session