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WAL-MART PHARMACY 10-1980
CH010220 Generations Family Health Center, Inc.
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Covered Entity Details
Entity Name
Generations Family Health Center, Inc.
Subdivision Name
Generations Family Health Center, Inc.
Type
HRSA-Funded Health Center
340B ID
CH010220
Entity Address
40 Mansfield Ave
Willimantic, CT 06226-2018
Grant Number
H80CS00155
Participating Start Date
1/1/2002
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1980
Pharmacy Address
625 SCHOOL ST
PUTNAM, CT 06260
Pharmacy Comments
Contract Details
Approval Date
7/15/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ARVIND SHAW, CEO
(860) 450-7471 Ext: 6200
Contract Pharmacy Representative
Wal-Mart
Marcus Osbourne, Vice President
(800) 939-2022
Signed By Date
7/15/2015
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