340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-1384
CH080170A PUEBLO COMMUNITY HEALTH CENTER
Print
Covered Entity Details
Entity Name
PUEBLO COMMUNITY HEALTH CENTER
Subdivision Name
Colorado Avenue Clinic
Type
HRSA-Funded Health Center
340B ID
CH080170A
Entity Address
300 Colorado Ave
Pueblo, CO 81004-2006
Grant Number
H80CS00692
Participating Start Date
1/1/2000
Last Recertification Date
3/2/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1384
Pharmacy Address
6 CONLEY ROAD
LA JUNTA, CO 81050
Pharmacy Comments
Contract Details
Approval Date
1/7/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Donald Moore, CEO
(719) 543-8718 Ext: 139
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/7/2020
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