340B Drug Pricing Program Database
WAL-MART PHARMACY 10-3771
CH093070 MOUNTAIN PARK HEALTH CENTER - information as of 5/14/2025 12:00:22 AM
Covered Entity Details
Entity Name
MOUNTAIN PARK HEALTH CENTER
Subdivision Name
Mountain Park Health Center - Baseline
Type
HRSA-Funded Health Center
340B ID
CH093070
Entity Address
635 E Baseline Rd
Phoenix, AZ 85042-6551
Grant Number
H80CS00141
Participating Start Date
10/1/1996
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3771
Pharmacy Address
6150 SOUTH 35TH AVE
PHOENIX, AZ 85041
Pharmacy Comments
Contract Details
Approval Date
7/11/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John R. Swagert, CEO
(602) 323-3470
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
7/11/2016
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