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WAL-MART PHARMACY 10-0586
CHC28973-00 GENESIS HEALTHCARE, INC
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Covered Entity Details
Entity Name
GENESIS HEALTHCARE, INC
Subdivision Name
Olanta Family Care
Type
HRSA-Funded Health Center
340B ID
CHC28973-00
Entity Address
211 S Jones Rd
Olanta, SC 29114-9705
Grant Number
H80CS28973
Participating Start Date
6/27/2018
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0586
Pharmacy Address
2709-A CHURCH STREET
CONWAY, SC 29526
Pharmacy Comments
Contract Details
Approval Date
7/5/2018
Contract Begin Date
6/27/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/23/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tony R. Megna, CEO
(803) 254-3676
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/3/2018
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