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WAL-MART PHARMACY 10-0911
CH0623760 JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC
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Covered Entity Details
Entity Name
JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC
Subdivision Name
Jefferson Community Health Care Centers-Avondale
Type
HRSA-Funded Health Center
340B ID
CH0623760
Entity Address
3932 U.S. Hwy 90
Avondale, LA 70094
Grant Number
H80CS06716
Participating Start Date
7/1/2006
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0911
Pharmacy Address
4810 LAPALCO BLVD
MARRERO, LA 70072
Pharmacy Comments
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shondra Williams, CEO
(504) 762-8931
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/15/2018
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