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WAL-MART CENTRAL FILL 10-2670
CH052200 DOWNRIVER COMMUNITY SERVICES INC
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Covered Entity Details
Entity Name
DOWNRIVER COMMUNITY SERVICES INC
Subdivision Name
DOWNRIVER COMMUNITY SERVICES, INC.
Type
HRSA-Funded Health Center
340B ID
CH052200
Entity Address
555 St Clair River Dr
Algonac, MI 48001-1802
Grant Number
H80CS00497
Participating Start Date
10/1/2001
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WAL-MART CENTRAL FILL 10-2670
Pharmacy Address
608 SPRING HILL DR # 3 SUITE 300
SPRING, TX 77386
Pharmacy Comments
Contract Details
Approval Date
7/11/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Baranowski, CEO
(586) 270-8055 Ext: 251
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/11/2017
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