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WAL-MART PHARMACY 10-2536
CH093640 FAMILY HEALTHCARE NETWORK
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Covered Entity Details
Entity Name
FAMILY HEALTHCARE NETWORK
Subdivision Name
FAMILY HEALTHCARE NETWORK - Porterville Health Center
Type
HRSA-Funded Health Center
340B ID
CH093640
Entity Address
1107 W Poplar Ave
Porterville, CA 93257-5839
Grant Number
H80CS00786
Participating Start Date
4/1/1997
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2536
Pharmacy Address
1110 EAST PROSPERITY AVE
TULARE, CA 93274
Pharmacy Comments
Contract Details
Approval Date
1/10/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kerry Hydash, President and CEO
(559) 737-4700
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
1/10/2014
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