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WAL-MART PHARMACY 10-2496
CHC24142-09 HIGH COUNTRY COMMUNITY HEALTH
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Covered Entity Details
Entity Name
HIGH COUNTRY COMMUNITY HEALTH
Subdivision Name
Eastern Burke HCCH
Type
HRSA-Funded Health Center
340B ID
CHC24142-09
Entity Address
560 Malcolm Blvd
Connelly Springs, NC 28612
Grant Number
H80CS24142
Participating Start Date
7/1/2020
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2496
Pharmacy Address
200 WATAUGA VILLAGE DR
BOONE, NC 28607
Pharmacy Comments
Contract Details
Approval Date
4/22/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tiffany Melchers, CFO
(828) 262-3886 Ext: 120
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/15/2020
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