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WAL-MART PHARMACY 10-2636
CH093110 ALTAMED Health Services Corporation
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Covered Entity Details
Entity Name
ALTAMED Health Services Corporation
Subdivision Name
AltaMed Health Services Corporation Headquarters
Type
HRSA-Funded Health Center
340B ID
CH093110
Entity Address
2040 CAMFIELD AVENUE
Commerce, CA 90040
Grant Number
H80CS00142
Participating Start Date
4/1/2001
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2636
Pharmacy Address
8230 TALBERT AVENUE
HUNTINGTON BEACH, CA 92646
Pharmacy Comments
Contract Details
Approval Date
10/11/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jose Esparza, Sr. VP, Finance & CFO
(323) 889-7320
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
10/11/2017
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