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WAL-MART PHARMACY 10-1179
CHC08217-00 LONGVIEW WELLNESS CENTER, INC.
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Covered Entity Details
Entity Name
LONGVIEW WELLNESS CENTER, INC.
Subdivision Name
Wellness Pointe - Longview Buliding 3
Type
HRSA-Funded Health Center
340B ID
CHC08217-00
Entity Address
1107 E. Marshall Avenue
Building 3
Longview, TX 75601
Grant Number
H80CS08217
Participating Start Date
10/1/2009
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1179
Pharmacy Address
60 AIRPORT ROAD
ARDEN, NC 28704
Pharmacy Comments
Contract Details
Approval Date
10/11/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/13/2022
Agreement registered in error
Contacts
Covered Entity Signing Official
Chad Jones, Chief Executive Officer
(903) 212-4777
Contract Pharmacy Representative
Walmart
Julie Howard, 340b Program Manager
(479) 739-1973 Ext: 4792771498
Signed By Date
10/11/2022
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