340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0056
CHC28965-00 FORDLAND CLINIC
Print
Covered Entity Details
Entity Name
FORDLAND CLINIC
Subdivision Name
Fordland Clinic
Type
HRSA-Funded Health Center
340B ID
CHC28965-00
Entity Address
1059 BARTON DR
FORDLAND, MO 65652-7350
Grant Number
H80CS28965
Participating Start Date
4/1/2016
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0056
Pharmacy Address
1309 NW 12TH AVE
AVA, MO 65608
Pharmacy Comments
Contract Details
Approval Date
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joan Twiton, Exec. Director
(417) 767-2273 Ext: 2022
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
7/15/2019
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