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WAL-MART CENTRAL FILL 10-2670
CHC12890-01 FAIRFIELD COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
FAIRFIELD COMMUNITY HEALTH CENTER
Subdivision Name
Fairfield Community Health Center - Hunter Trace
Type
HRSA-Funded Health Center
340B ID
CHC12890-01
Entity Address
216 Trace Dr
Lancaster, OH 43130-4151
Grant Number
H80CS19595
Participating Start Date
7/1/2011
Last Recertification Date
1/30/2023
Entity Termination Date
10/1/2023
Pharmacy Details
Pharmacy Name
WAL-MART CENTRAL FILL 10-2670
Pharmacy Address
608 SPRING HILL DR # 3 SUITE 300
SPRING, TX 77386
Pharmacy Comments
Contract Details
Approval Date
10/11/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Lauree Althaus, Director of Finance
(740) 277-6043 Ext: 1001
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
10/11/2018
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