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WAL-MART CENTRAL FILL 10-2670
CH033010 THREE LOWER COUNTIES COMMUNITY SERVICES, INC.
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Covered Entity Details
Entity Name
THREE LOWER COUNTIES COMMUNITY SERVICES, INC.
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH033010
Entity Address
32033 BEAVER RUN DR
SALISBURY, MD 21804-1773
Grant Number
H80CS00774
Participating Start Date
4/1/2015
Last Recertification Date
2/10/2025
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
7/14/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Susanne Gray, CEO/President
(410) 749-1015
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
7/14/2017
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