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WAL-MART PHARMACY 10-0484
CHC24170-02 HEARTLAND MEDICAL CLINIC, INC
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Covered Entity Details
Entity Name
HEARTLAND MEDICAL CLINIC, INC
Subdivision Name
Heartland Community Health Center - 6th Street
Type
HRSA-Funded Health Center
340B ID
CHC24170-02
Entity Address
1312 W 6th St
Lawrence, KS 66044
Grant Number
H80CS24170
Participating Start Date
4/1/2017
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0484
Pharmacy Address
3300 IOWA STREET
LAWRENCE, KS 66046
Pharmacy Comments
Contract Details
Approval Date
10/8/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Julie Boden Schmidt, Chief Executive Officer
(785) 841-7297
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
10/8/2021
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