Contract Pharmacy Details

WAL-MART PHARMACY 10-0989
CH0623760 JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC

Covered Entity Details

Entity Name

JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC

Subdivision Name

Jefferson Community Health Care Centers-Avondale

Type

HRSA-Funded Health Center

340B ID

CH0623760

Entity Address

3932 U.S. Hwy 90
Avondale, LA 70094

Grant Number

H80CS06716

Participating Start Date

7/1/2006

Last Recertification Date

2/26/2025

Pharmacy Details

Pharmacy Name

WAL-MART PHARMACY 10-0989

Pharmacy Address

8912 VETERANS MEMORIAL BLVD
METAIRIE, LA 70003

Pharmacy Comments

Contract Details

Approval Date

4/15/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/6/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Shondra Williams, CEO
(504) 762-8931

Contract Pharmacy Representative

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

Signed By Date

4/15/2019

340B Drug Pricing Program Database