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WAL-MART PHARMACY 10-2490
FQHCLA366A Turner House Clinic Inc.
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Covered Entity Details
Entity Name
Turner House Clinic Inc.
Subdivision Name
Wyandotte Community Health Center - CCKC
Type
Health Center Program Look-Alike
340B ID
FQHCLA366A
Entity Address
444 Minnesota Ave, Suite 100
Kansas City, KS 66101-2914
Grant Number
LALCS31599
Participating Start Date
7/1/2018
Last Recertification Date
2/1/2019
Entity Termination Date
4/1/2020
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2490
Pharmacy Address
5150 ROE AVE
ROELAND PARK, KS 66205
Pharmacy Comments
Contract Details
Approval Date
10/12/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Patrick Sallee, CEO
(913) 342-2552
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/12/2018
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