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WALMART PHARMACY 10-6172
FQHCLA366B Turner House Clinic Inc.
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Covered Entity Details
Entity Name
Turner House Clinic Inc.
Subdivision Name
Wyandotte Community Health Center - Turner House Children&s Clinic
Type
Health Center Program Look-Alike
340B ID
FQHCLA366B
Entity Address
21 N 12th St Ste 300
Kansas City, KS 66102-5105
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
WALMART PHARMACY 10-6172
Pharmacy Address
2300 METROPOLITAN AVE
KANSAS CITY, KS 66106
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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