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WAL-MART PHARMACY 10-2641
FQHCLA410 Star Community Health, Inc.
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Covered Entity Details
Entity Name
Star Community Health, Inc.
Subdivision Name
Star Community Health Administration
Type
Health Center Program Look-Alike
340B ID
FQHCLA410
Entity Address
520 E Broad St Ste 108
Bethlehem, PA 18018-6330
Grant Number
LALCS33897
Participating Start Date
10/1/2020
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2641
Pharmacy Address
1091 MILLCREEK ROAD
ALLENTOWN, PA 18106
Pharmacy Comments
Contract Details
Approval Date
1/13/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christine Davco, CEO
(610) 841-6180
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/13/2021
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