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WALMART PHARMACY 10-4129
CH061335A ST. CHARLES COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
ST. CHARLES COMMUNITY HEALTH CENTER, INC.
Subdivision Name
ST. CHARLES COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH061335A
Entity Address
843 Milling Ave
Luling, LA 70070-4442
Grant Number
H80CS00867
Participating Start Date
10/1/2003
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-4129
Pharmacy Address
1331 HIGHWAY 51
PONCHATOULA, LA 70454
Pharmacy Comments
Contract Details
Approval Date
4/15/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARK F. KEISER, CEO
(504) 575-3746
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/15/2022
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