340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0051
CH075300 FAMILY HEALTH CENTER OF BOONE COUNTY
Print
Covered Entity Details
Entity Name
FAMILY HEALTH CENTER OF BOONE COUNTY
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH075300
Entity Address
1001 W. WORLEY
COLUMBIA, MO 65203-2037
Grant Number
H80CS00573
Participating Start Date
7/1/2000
Last Recertification Date
1/28/2020
Entity Termination Date
1/1/2021
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0051
Pharmacy Address
1701 NO BLUFF STREET
FULTON, MO 65251
Pharmacy Comments
Contract Details
Approval Date
4/13/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
GLORIA L. CRULL, CEO
(573) 886-6713
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
4/13/2017
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session