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WAL-MART PHARMACY 10-5858
CH090080 MARANA HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
MARANA HEALTH CENTER, INC.
Subdivision Name
Marana Health Center, Inc.
Type
HRSA-Funded Health Center
340B ID
CH090080
Entity Address
13395 N. Marana Main Street
MARANA, AZ 85653
Grant Number
H80CS00231
Participating Start Date
7/1/1999
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5858
Pharmacy Address
9260 S. HOUGHTON RD
TUCSON, AZ 85747
Pharmacy Comments
Contract Details
Approval Date
4/12/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tamie Olson, Chief Financial Officer
(520) 682-4111 Ext: 6221
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
4/12/2019
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