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WAL-MART PHARMACY 10-3489
CH030150 Total Health Care, Inc.
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Covered Entity Details
Entity Name
Total Health Care, Inc.
Subdivision Name
Division Health Center
Type
HRSA-Funded Health Center
340B ID
CH030150
Entity Address
1501 DIVISION STREET
BALTIMORE, MD 21217
Grant Number
H80CS00068
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3489
Pharmacy Address
6420 PETRIE WAY
BALTIMORE (ROSEDALE), MD 21237
Pharmacy Comments
Contract Details
Approval Date
7/16/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Danny Bellamy, CEO
(410) 728-4090
Contract Pharmacy Representative
Walmart
George Flaherty, Senior Director Payer Programs
(479) 204-9374
Signed By Date
7/16/2021
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