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WAL-MART PHARMACY 10-0034
CH077570 COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
Subdivision Name
COMMUNITY HEALTH CENTER OF SOUTHEAST KS
Type
HRSA-Funded Health Center
340B ID
CH077570
Entity Address
3011 N Michigan St
Pittsburg, KS 66762-2546
Grant Number
H80CS00841
Participating Start Date
1/1/2005
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0034
Pharmacy Address
2250 LINCOLN AVE
NEVADA, MO 64772
Pharmacy Comments
Contract Details
Approval Date
4/8/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KRISTA POSTAI, CEO
(620) 235-1867
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/8/2020
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