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WAL-MART PHARMACY 10-1121
CH04518K COMMUNITY HEALTH CARE SYSTEMS INC
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CARE SYSTEMS INC
Subdivision Name
TriCounty Health System - Sparta
Type
HRSA-Funded Health Center
340B ID
CH04518K
Entity Address
675 HAMILTON ST
SPARTA, GA 31087-1837
Grant Number
H80CS00507
Participating Start Date
1/1/2015
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1121
Pharmacy Address
2592 N COLUMBIA ST
MILLEDGEVILLE, GA 31061
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
Carla Belcher, CEO
(478) 552-7384 Ext: 1211
Contract Pharmacy Representative
RX Strategies
Cheyenne Boynton, Sr. Implementation Manager
(954) 602-0609
Signed By Date
7/15/2019
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