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WAL-MART PHARMACY 10-3049
CH090160 EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
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Covered Entity Details
Entity Name
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
Subdivision Name
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH090160
Entity Address
839 WEST CONGRESS ST
TUCSON, AZ 85745
Grant Number
H80CS00230
Participating Start Date
12/1/1992
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3049
Pharmacy Address
2550 S. KOLB RD.
TUCSON, AZ 85710
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nancy Johnson, CEO
(520) 309-2011
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/15/2020
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