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WAL-MART PHARMACY 10-1414
CH060240 FIRST CHOICE COMMUNITY HEALTHCARE
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Covered Entity Details
Entity Name
FIRST CHOICE COMMUNITY HEALTHCARE
Subdivision Name
FIRST CHOICE COMMUNITY HEALTH CARE
Type
HRSA-Funded Health Center
340B ID
CH060240
Entity Address
2001 NORTH CENTRO FAMILIAR BOU
ALBUQUERQUE, NM 87105-0000
Grant Number
H80CS00202
Participating Start Date
12/1/1992
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1414
Pharmacy Address
1 I-25 BYPASS
BELEN, NM 87002
Pharmacy Comments
Contract Details
Approval Date
1/14/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert DeFelice, CEO
(505) 873-7401
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/14/2019
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