340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-5437
CH053020 WEST SIDE COMMUNITY HEALTH SERVICES, INC.
Print
Covered Entity Details
Entity Name
WEST SIDE COMMUNITY HEALTH SERVICES, INC.
Subdivision Name
WESTSIDE COMMUNITY HEALTH SERVICES, INC.
Type
HRSA-Funded Health Center
340B ID
CH053020
Entity Address
153 Cesar Chavez St
Saint Paul, MN 55107-2226
Grant Number
H80CS00790
Participating Start Date
1/1/1997
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5437
Pharmacy Address
1450 UNIVERSITY AVE W
ST PAUL (MIDWAY), MN 55104
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
9/13/2019
Pharmacy closed
Contacts
Covered Entity Signing Official
Reuben Moore, President & Executive Officer
(651) 602-7536
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/15/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session