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WALMART PHARMACY 10-3035
CHC10591-10 COMMUNITY CLINIC, INC., THE
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Covered Entity Details
Entity Name
COMMUNITY CLINIC, INC., THE
Subdivision Name
Community Clinic Inc
Type
HRSA-Funded Health Center
340B ID
CHC10591-10
Entity Address
8630 Fenton Street
Suite 1204
Silver Spring, MD 20910-3806
Grant Number
H80CS10591
Participating Start Date
10/1/2014
Last Recertification Date
2/3/2022
Entity Termination Date
7/1/2022
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-3035
Pharmacy Address
310 RIGGS RD N.E.
WASHINGTON, DC 20011
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Sonya J. Bruton, CEO and President
(240) 839-5107
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/15/2020
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