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WAL-MART PHARMACY 10-1745
FQHCLA393 Neighborhood Health Center, INC
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Covered Entity Details
Entity Name
Neighborhood Health Center, INC
Subdivision Name
Neighborhood Health Center, Inc.
Type
Health Center Program Look-Alike
340B ID
FQHCLA393
Entity Address
101 S 10th St
Richmond, IN 47374-5547
Grant Number
LALCS32717
Participating Start Date
10/1/2019
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1745
Pharmacy Address
3601 E. MAIN
RICHMOND, IN 47374
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carrie N Miles, CEO
(765) 965-4299
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/15/2019
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