340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-2681
CH010850 COOS COUNTY FAMILY HEALTH SERVICES, INC.
Print
Covered Entity Details
Entity Name
COOS COUNTY FAMILY HEALTH SERVICES, INC.
Subdivision Name
COOS COUNTY FAMILY HEALTH SVCS
Type
HRSA-Funded Health Center
340B ID
CH010850
Entity Address
133 Pleasant St
Berlin, NH 03570-2006
Grant Number
H80CS00508
Participating Start Date
7/1/2004
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2681
Pharmacy Address
615 MEADOW STREET
LITTLETON, NH 03561
Pharmacy Comments
Contract Details
Approval Date
1/14/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KEN GORDON, CEO
(603) 752-2040 Ext: 4018
Contract Pharmacy Representative
Wal-Mart
Jodi Prohofsky, Sr. Director, Payer Relations
(254) 301-6601
Signed By Date
1/14/2020
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