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SAVE MART PHARMACY #89
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
SAVE MART PHARMACY #89
Pharmacy Address
5201 W. GOSHEN AVE
VISALIA, CA 93291
Pharmacy Comments
Contract Details
Approval Date
7/5/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/30/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Kerry Hydash, President and CEO
(559) 737-4700
Contract Pharmacy Representative
Robert Vaughan, Senior Director of Pharmacy Operations
(209) 574-6220
Signed By Date
7/5/2016
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