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WAL-MART PHARMACY 10-2149
CHC30716-00 KNOX, COUNTY OF
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Covered Entity Details
Entity Name
KNOX, COUNTY OF
Subdivision Name
Danville Community Health Center
Type
HRSA-Funded Health Center
340B ID
CHC30716-00
Entity Address
12 East Main Street
Danville, OH 43014
Grant Number
H80CS30716
Participating Start Date
4/1/2020
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2149
Pharmacy Address
1575 COSHOCTON AVE
MT VERNON, OH 43050
Pharmacy Comments
Contract Details
Approval Date
7/14/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lane K Belangia, CEO
(740) 392-2222 Ext: 2275
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
7/14/2021
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