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WAL-MART PHARMACY 10-2005
CH044523C CABARRUS COMMUNITY HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
CABARRUS COMMUNITY HEALTH CENTERS, INC.
Subdivision Name
China Grove Family Medicine
Type
HRSA-Funded Health Center
340B ID
CH044523C
Entity Address
307 East Thom Street
China Grove, NC 28023
Grant Number
H80CS06652
Participating Start Date
4/1/2015
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2005
Pharmacy Address
2420 SUPERCENTER DR NE
KANNAPOLIS, NC 28083
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
Don Holloman, CEO
(704) 792-2203
Contract Pharmacy Representative
Wal-Mart
Jodi Prohofsky, Sr. Director, Payer Relations
(254) 301-6601
Signed By Date
1/15/2020
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