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WAL-MART PHARMACY 10-3717
CH04411S UNITED NEIGHBORHOOD HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
UNITED NEIGHBORHOOD HEALTH SERVICES, INC.
Subdivision Name
Dickerson Road Family Clinic
Type
HRSA-Funded Health Center
340B ID
CH04411S
Entity Address
1223 Dickerson Road
Nashville, TN 37207-5408
Grant Number
H80CS00394
Participating Start Date
4/1/2013
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3717
Pharmacy Address
4040 NOLENSVILLE PIKE
NASHVILLE, TN 37211
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mary Bufwack, CEO
(615) 227-3000 Ext: 1024
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/15/2020
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