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WAL-MART PHARMACY 10-5635
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 10-5635
Pharmacy Address
1320 N DEMAREE ST
VISALIA, CA 93291
Pharmacy Comments
Contract Details
Approval Date
4/19/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kerry Hydash, President and CEO
(559) 737-4700
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/19/2016
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