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WAL-MART PHARMACY 10-3480
CH031810 SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS, INC.
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Covered Entity Details
Entity Name
SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS, INC.
Subdivision Name
Saltville Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH031810
Entity Address
308 WEST MAIN STREET
SALTVILLE, VA 24370
Grant Number
H80CS00278
Participating Start Date
1/1/2002
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3480
Pharmacy Address
1050 REGIONAL PARK ROAD
LEBANON, VA 24266
Pharmacy Comments
Contract Details
Approval Date
7/5/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/17/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Bryan Haynes, CEO
(276) 496-4492 Ext: 1004
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/5/2018
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