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WAL-MART PHARMACY 10-5997
CHC24160-00 Neighborhood Health Center
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Covered Entity Details
Entity Name
Neighborhood Health Center
Subdivision Name
NHC Administration and Pharmacy
Type
HRSA-Funded Health Center
340B ID
CHC24160-00
Entity Address
7320 SW Hunziker Rd STE 300
Portland, OR 97223
Grant Number
H80CS24160
Participating Start Date
1/1/2015
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5997
Pharmacy Address
9600 PARKSOUTH CT. SUITE 100
ORLANDO, FL 32837
Pharmacy Comments
Contract Details
Approval Date
1/14/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Blain A. West, CFO / COO
(503) 941-3028
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/14/2021
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