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WAL-MART PHARMACY 10-2225
CH011820 THUNDERMIST HEALTH CENTER
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Covered Entity Details
Entity Name
THUNDERMIST HEALTH CENTER
Subdivision Name
THUNDERMIST DENTAL ADMIN WOONSOCKET
Type
HRSA-Funded Health Center
340B ID
CH011820
Entity Address
25 John A. Cummings Way
Woonsocket, RI 02895-3240
Grant Number
H80CS00454
Participating Start Date
10/1/2002
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2225
Pharmacy Address
7 DOWLING VILLAGE BLVD
NORTH SMITHFIELD, RI 02896
Pharmacy Comments
Contract Details
Approval Date
1/16/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Charles T. Jones, President/CEO
(401) 767-4100 Ext: 3176
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
1/16/2014
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