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SAN JOAQUIN DRUG
CH090470 GOLDEN VALLEY HEALTH CENTERS
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Covered Entity Details
Entity Name
GOLDEN VALLEY HEALTH CENTERS
Subdivision Name
GVHC - MERCED SUITES
Type
HRSA-Funded Health Center
340B ID
CH090470
Entity Address
847 W. CHILDS AVE
MERCED, CA 95341-6862
Grant Number
H80CS00742
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SAN JOAQUIN DRUG
Pharmacy Address
9215 EAST HIGHWAY 140
P.O. BOX 1636
PLANADA, CA 95365
Pharmacy Comments
Contract Details
Approval Date
10/15/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/30/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Tony Weber, CEO
(209) 385-5551
Contract Pharmacy Representative
Signed By Date
10/15/2014
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