Contract Pharmacy Details

WAL-MART PHARMACY 10-4108
CH0619500 ST. FRANCIS HOUSE NWA, INC.

Covered Entity Details

Entity Name

ST. FRANCIS HOUSE NWA, INC.

Subdivision Name

Community Clinic Springdale Medical

Type

HRSA-Funded Health Center

340B ID

CH0619500

Entity Address

614 E Emma Ave STE 300
Springdale, AR 72764-4469

Grant Number

H80CS04290

Participating Start Date

4/1/2005

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WAL-MART PHARMACY 10-4108

Pharmacy Address

4870 ELM SPRINGS ROAD
SPRINGDALE, AR 72762

Pharmacy Comments

Contract Details

Approval Date

4/13/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Kathy Grisham, CEO
(479) 751-7417 Ext: 6070

Contract Pharmacy Representative

Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498

Signed By Date

4/13/2019

340B Drug Pricing Program Database