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WAL-MART CENTRAL FILL 10-2670
CH078170 Bluestem Health
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Covered Entity Details
Entity Name
Bluestem Health
Subdivision Name
Bluestem Health
Type
HRSA-Funded Health Center
340B ID
CH078170
Entity Address
1021 N 27th St
Lincoln, NE 68503-1803
Grant Number
H80CS00236
Participating Start Date
1/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART CENTRAL FILL 10-2670
Pharmacy Address
608 SPRING HILL DR # 3 SUITE 300
SPRING, TX 77386
Pharmacy Comments
Contract Details
Approval Date
7/5/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brad Lee Meyer, Chief Executive Officer
(402) 470-5424
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
7/5/2017
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