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WAL-MART PHARMACY 10-1509
CH071170 COMMUNITY HEALTH CARE, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CARE, INC.
Subdivision Name
Community Health Care, Inc. River Drive Clinic
Type
HRSA-Funded Health Center
340B ID
CH071170
Entity Address
500 W River Dr
Davenport, IA 52801
Grant Number
H80CS00670
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1509
Pharmacy Address
103 E. CARLISLE
MAQUOKETA, IA 52060
Pharmacy Comments
Contract Details
Approval Date
1/7/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas Bowman, CEO
(563) 336-3112
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/7/2021
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