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WAL-MART PHARMACY 10-1109
CHC24167-03 RICHLAND, PARISH OF
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Covered Entity Details
Entity Name
RICHLAND, PARISH OF
Subdivision Name
Delhi Charter School Based Health Center
Type
HRSA-Funded Health Center
340B ID
CHC24167-03
Entity Address
6940 Highway 17
Delhi, LA 71232-7021
Grant Number
H80CS24167
Participating Start Date
10/1/2014
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1109
Pharmacy Address
1806 S JULIA ST
RAYVILLE, LA 71269
Pharmacy Comments
Contract Details
Approval Date
7/9/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Barbara Hutchinson, CEO
(318) 878-6650
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
7/9/2018
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