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WAL-MART PHARMACY 10-1795
CH04094BN Blue Ridge Community Health Services, Inc.
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Covered Entity Details
Entity Name
Blue Ridge Community Health Services, Inc.
Subdivision Name
Pardee BlueMD 1824 Pisgah Drive
Type
HRSA-Funded Health Center
340B ID
CH04094BN
Entity Address
1824 Pisgah Drive
Hendersonville, NC 28791-3579
Grant Number
H80CS00650
Participating Start Date
9/13/2022
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1795
Pharmacy Address
177 FOREST GATE DR
PISGAH FOREST, NC 28768
Pharmacy Comments
Contract Details
Approval Date
10/4/2022
Contract Begin Date
10/5/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Sunday, VP Finance, CFO
(828) 696-1175
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/4/2022
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