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WAL-MART CENTRAL FILL 10-2670
CH056420 LAWNDALE CHRISTIAN HEALTH CENTER
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Covered Entity Details
Entity Name
LAWNDALE CHRISTIAN HEALTH CENTER
Subdivision Name
Lawndale Christian Health Center Main Clinic
Type
HRSA-Funded Health Center
340B ID
CH056420
Entity Address
3860 W Ogden Ave
Chicago, IL 60623-2460
Grant Number
H80CS00725
Participating Start Date
12/1/1992
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
4/10/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alyssa Sianghio, Chief Administrative Officer (CAO)
(872) 588-3015
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/10/2019
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