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WAL-MART PHARMACY 10-0698
CH04123B OCOEE REGIONAL HEALTH CORPORATION
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Covered Entity Details
Entity Name
OCOEE REGIONAL HEALTH CORPORATION
Subdivision Name
RHEA COUNTY PRIMARY CARE CENTER
Type
HRSA-Funded Health Center
340B ID
CH04123B
Entity Address
8850 Rhea County Hwy
DAYTON, TN 37321-7932
Grant Number
H80CS00762
Participating Start Date
7/1/2015
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0698
Pharmacy Address
4495 KEITH STREET NW
CLEVELAND, TN 37312
Pharmacy Comments
Contract Details
Approval Date
10/16/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
BILL MOATS, CEO
(423) 338-8995 Ext: 1212
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
10/16/2015
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