340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0204
CHC17157-00 REGIONAL HEALTH CARE AFFILIATES, INC.
Print
Covered Entity Details
Entity Name
REGIONAL HEALTH CARE AFFILIATES, INC.
Subdivision Name
Regional Health Care Affiliates, Inc. Doing Business As Health First CHC - Providence
Type
HRSA-Funded Health Center
340B ID
CHC17157-00
Entity Address
215 East Main Street
Providence, KY 42450-1261
Grant Number
H80CS17157
Participating Start Date
7/1/2010
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0204
Pharmacy Address
1500 US 62 WEST
PRINCETON, KY 42445
Pharmacy Comments
Contract Details
Approval Date
1/3/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shelley Renea Gobin, CEO
(270) 667-2535 Ext: 2104
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/3/2019
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