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WALMART PHARMACY 10-3585
CH0622370 SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
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Covered Entity Details
Entity Name
SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
Subdivision Name
SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
Type
HRSA-Funded Health Center
340B ID
CH0622370
Entity Address
725 PATE STREET
ALBANY, TX 76430-2435
Grant Number
H80CS06460
Participating Start Date
12/16/2005
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-3585
Pharmacy Address
2901 RILEY FUZZELL RD
SPRING, TX 77386
Pharmacy Comments
Contract Details
Approval Date
4/15/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/15/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Meagan Marshall, CEO
(325) 762-2447 Ext: 110
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/15/2016
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