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WALMART PHARMACY 10-4516
CH0619500 ST. FRANCIS HOUSE NWA, INC.
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Covered Entity Details
Entity Name
ST. FRANCIS HOUSE NWA, INC.
Subdivision Name
Community Clinic Springdale Medical
Type
HRSA-Funded Health Center
340B ID
CH0619500
Entity Address
614 E Emma Ave STE 300
Springdale, AR 72764-4469
Grant Number
H80CS04290
Participating Start Date
4/1/2005
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-4516
Pharmacy Address
660 WEST MARTIN LUTHER KING BOULEVARD
FAYETTEVILLE, AR 72701
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
Kathy Grisham, CEO
(479) 751-7417 Ext: 6070
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/15/2019
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