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WAL-MART PHARMACY 10-3889
CH041000 Advance Community Health, Inc.
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Covered Entity Details
Entity Name
Advance Community Health, Inc.
Subdivision Name
Southeast Raleigh - South
Type
HRSA-Funded Health Center
340B ID
CH041000
Entity Address
1011 Rock Quarry Rd
Raleigh, NC 27610
Grant Number
H80CS00087
Participating Start Date
7/1/2001
Last Recertification Date
2/16/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3889
Pharmacy Address
3151 APEX PEAKWAY
APEX, NC 27502
Pharmacy Comments
Contract Details
Approval Date
4/8/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Penella M. Washington, CEO
(919) 250-2923
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/8/2019
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