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WAL-MART CENTRAL FILL 10-2670
CH083270 BUTTE-SILVER BOW PRIMARY HEALTH CARE CLINIC, INC
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Covered Entity Details
Entity Name
BUTTE-SILVER BOW PRIMARY HEALTH CARE CLINIC, INC
Subdivision Name
BUTTE-SILVER BOW PRIMARY HEALTH CARE
Type
HRSA-Funded Health Center
340B ID
CH083270
Entity Address
445 Centennial Ave.
Butte, MT 59701-2870
Grant Number
H80CS00799
Participating Start Date
7/1/1998
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
WAL-MART CENTRAL FILL 10-2670
Pharmacy Address
608 SPRING HILL DR # 3 SUITE 300
SPRING, TX 77386
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
Jennifer Malone, Chief Executive Officer
(406) 496-6018
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/15/2019
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