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WALMART PHARMACY 10-4619
CH046860 ACCESS FAMILY HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
ACCESS FAMILY HEALTH SERVICES, INC.
Subdivision Name
Access Family Health Services-Smithville
Type
HRSA-Funded Health Center
340B ID
CH046860
Entity Address
60021 MONROE ST
Smithville, MS 38870-9700
Grant Number
H80CS00633
Participating Start Date
1/1/2000
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-4619
Pharmacy Address
316 S. GLOSTER STREET
TUPELO, MS 38801
Pharmacy Comments
Contract Details
Approval Date
10/14/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARILYN SUMERFORD, CEO
(662) 651-4686 Ext: 8103
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/14/2019
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