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WAL-MART PHARMACY 10-5477
CH0719300 COMPASS HEALTH, INC
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Covered Entity Details
Entity Name
COMPASS HEALTH, INC
Subdivision Name
Compass Health Inc.
Type
HRSA-Funded Health Center
340B ID
CH0719300
Entity Address
1032 CROSSWINDS CT
WENTZVILLE, MO 63385-4836
Grant Number
H80CS26563
Participating Start Date
9/1/2008
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5477
Pharmacy Address
401 SUPERCENTER DR.
JEFFERSON CITY, MO 65101
Pharmacy Comments
Contract Details
Approval Date
10/1/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/14/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jake Matthew Krafve, Chief Financial Officer
(636) 332-8392
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
10/1/2019
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