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WAL-MART PHARMACY 10-1326
CHC26562-01 Heartland Health Center, Inc.
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Covered Entity Details
Entity Name
Heartland Health Center, Inc.
Subdivision Name
Heartland Health Center - Grand Island
Type
HRSA-Funded Health Center
340B ID
CHC26562-01
Entity Address
2116 W Faidley Ave Ste 2100
Grand Island, NE 68803
Grant Number
H80CS26562
Participating Start Date
4/1/2020
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1326
Pharmacy Address
2250 NO. DIERS AVE
GRAND ISLAND, NE 68803
Pharmacy Comments
Contract Details
Approval Date
6/9/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tami Smith, CEO
(308) 675-4223
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
6/9/2022
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