340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-5997
CH0611930 KIAMICHI FAMILY MEDICAL CENTER
Print
Covered Entity Details
Entity Name
KIAMICHI FAMILY MEDICAL CENTER
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH0611930
Entity Address
6026 BATTIEST PICKENS RD
BROKEN BOW, OK 74728-5037
Grant Number
H80CS00267
Participating Start Date
1/1/2003
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5997
Pharmacy Address
9600 PARKSOUTH CT. SUITE 100
ORLANDO, FL 32837
Pharmacy Comments
Contract Details
Approval Date
7/17/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Amy Gilbreath, CEO
(580) 241-5294 Ext: 234
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/17/2017
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session