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WAL-MART PHARMACY 10-2194
CH03702A UNITY HEALTH CARE INC
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Covered Entity Details
Entity Name
UNITY HEALTH CARE INC
Subdivision Name
Upper Cardozo Health Center
Type
HRSA-Funded Health Center
340B ID
CH03702A
Entity Address
3020 14th Street, NW
Washington, DC 20009
Grant Number
H80CS00070
Participating Start Date
1/1/2004
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2194
Pharmacy Address
5885 KINGSTOWNE BLVD
ALEXANDRIA, VA 22315
Pharmacy Comments
Contract Details
Approval Date
1/12/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
VINCENT A. KEANE, CEO
(202) 715-6562
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/12/2016
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