340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-4336
CH093030 ADELANTE HEALTHCARE, INC.
Print
Covered Entity Details
Entity Name
ADELANTE HEALTHCARE, INC.
Subdivision Name
Adelante Healthcare
Type
HRSA-Funded Health Center
340B ID
CH093030
Entity Address
3033 N. Central Ave.
Phoenix, AZ 85012-4403
Grant Number
H80CS00140
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-4336
Pharmacy Address
12900 WEST THUNDERBIRD
EL MIRAGE, AZ 85335
Pharmacy Comments
Contract Details
Approval Date
10/5/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Eric Battis, COO
(623) 583-3001 Ext: 1222
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
10/5/2017
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session