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WAL-MART PHARMACY 10-0780
CH040390 MEDLINK GEORGIA, INC.
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Covered Entity Details
Entity Name
MEDLINK GEORGIA, INC.
Subdivision Name
Medlink Colbert
Type
HRSA-Funded Health Center
340B ID
CH040390
Entity Address
11 CHARLIE MORRIS RD
COLBERT, GA 30628
Grant Number
H80CS00427
Participating Start Date
7/1/2005
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0780
Pharmacy Address
2050 W SPRING ST
MONROE, GA 30655
Pharmacy Comments
Contract Details
Approval Date
4/14/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dave Ward, CEO
(706) 788-3234
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/14/2021
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