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WAL-MART PHARMACY 10-5134
CH091600 Omni Family Health
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Covered Entity Details
Entity Name
Omni Family Health
Subdivision Name
Omni Family Health
Type
HRSA-Funded Health Center
340B ID
CH091600
Entity Address
277 East Front Street
Buttonwillow, CA 93206
Grant Number
H80CS00615
Participating Start Date
12/1/1992
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5134
Pharmacy Address
5075 GOSFORD ROAD
BAKERSFIELD, CA 93313
Pharmacy Comments
Contract Details
Approval Date
10/12/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Diego Martinez, Chief Operations Officer
(661) 630-7030
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/12/2017
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