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WALMART PHARMACY #10-4169
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
WALMART PHARMACY #10-4169
Pharmacy Address
300 N. 2ND ST
EL CAJON, CA 92021
Pharmacy Comments
Contract Details
Approval Date
4/10/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
TRACY REAM, CEO
(760) 520-8375
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
4/10/2014
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