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WAL-MART PHARMACY 10-3524
CH093540 NEIGHBORHOOD HEALTHCARE
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Covered Entity Details
Entity Name
NEIGHBORHOOD HEALTHCARE
Subdivision Name
RAY M. DICKINSON WELLNESS CENTER
Type
HRSA-Funded Health Center
340B ID
CH093540
Entity Address
425 N. DATE ST
ESCONDIDO, CA 92025-3413
Grant Number
H80CS00285
Participating Start Date
4/1/1996
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3524
Pharmacy Address
605 FLETCHER PKWY
EL CAJON (C), CA 92020
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
2/9/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
LISA DAIGLE, CFO
(760) 737-6901
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
9/7/2012
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