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WAL-MART PHARMACY 10-3515
CHC33657-01 Highland Health Providers Corporation
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Covered Entity Details
Entity Name
Highland Health Providers Corporation
Subdivision Name
Highland Health Providers - Rocky Fork Medical Center
Type
HRSA-Funded Health Center
340B ID
CHC33657-01
Entity Address
11130 N Shore Dr
Hillsboro, OH 45133
Grant Number
H80CS33657
Participating Start Date
4/1/2020
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3515
Pharmacy Address
540 HARRY SAUNER ROAD
HILLSBORO, OH 45133
Pharmacy Comments
Contract Details
Approval Date
2/27/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Meghann Ackley, Chief Financial Officer
(937) 840-6617
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
2/27/2020
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