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WAL-MART PHARMACY 10-2706
CH0623760 JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC
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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 10-2706
Pharmacy Address
1501 MANHATTAN BLVD
HARVEY, LA 70058
Pharmacy Comments
Contract Details
Approval Date
4/15/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
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
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