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WAL-MART PHARMACY 10-5881
CH033930 CHESPENN HEALTH SERVICES
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Covered Entity Details
Entity Name
CHESPENN HEALTH SERVICES
Subdivision Name
CHESPENN HEALTH SERVICES
Type
HRSA-Funded Health Center
340B ID
CH033930
Entity Address
1510 Chester Pike, Suite 200
Eddystone, PA 19022
Grant Number
H80CS00738
Participating Start Date
1/1/2003
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5881
Pharmacy Address
400 S STATE ROAD
SPRINGFIELD, PA 19064
Pharmacy Comments
Contract Details
Approval Date
7/20/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/16/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michael G. Lucas, CEO and President
(610) 485-3800 Ext: 630
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
7/20/2015
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