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WAL-MART CENTRAL FILL 10-2670
CHC28352-00 ISABELLA CITIZENS FOR HEALTH, INC.
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Covered Entity Details
Entity Name
ISABELLA CITIZENS FOR HEALTH, INC.
Subdivision Name
Isabella Citizens for Health
Type
HRSA-Funded Health Center
340B ID
CHC28352-00
Entity Address
2940 Health Pkwy
Mount Pleasant, MI 48858-9342
Grant Number
H80CS28352
Participating Start Date
4/1/2016
Last Recertification Date
2/4/2019
Entity Termination Date
4/1/2020
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
4/2/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Jennifer White, Chief Executive Officer
(989) 953-5191 Ext: 1
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/2/2019
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