340B Drug Pricing Program Database
Walmart Pharmacy 10-7611
CH09287S CHIRICAHUA COMMUNITY HEALTH CENTERS INC - information as of 4/25/2025 6:51:02 PM
Covered Entity Details
Entity Name
CHIRICAHUA COMMUNITY HEALTH CENTERS INC
Subdivision Name
CCHCI Mobile Medical Unit 'Murphy'
Type
HRSA-Funded Health Center
340B ID
CH09287S
Entity Address
1100 F Ave
Douglas, AZ 85607-1919
Grant Number
H80CS00696
Participating Start Date
4/1/2022
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jonathan Melk, CEO
(520) 227-9167
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/16/2023
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