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WAL-MART PHARMACY 10-2370
CH020110 WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.
Subdivision Name
WHITNEY M. YOUNG, JR. HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH020110
Entity Address
920 Lark Dr
Albany, NY 12207-1300
Grant Number
H80CS00433
Participating Start Date
10/1/1995
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2370
Pharmacy Address
760 HOOSICK RD
TROY, NY 12180
Pharmacy Comments
Contract Details
Approval Date
1/17/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Harold Shippee, President & CEO
(518) 591-4459
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/17/2020
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