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WALMART PHARMACY 10-5169
CHC26636-03 Rockbridge Area Free Clinic
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Covered Entity Details
Entity Name
Rockbridge Area Free Clinic
Subdivision Name
RAHC - Buena Vista
Type
HRSA-Funded Health Center
340B ID
CHC26636-03
Entity Address
2127 Magnolia Ave
Buena Vista, VA 24416-3111
Grant Number
H80CS26636
Participating Start Date
4/1/2023
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
Pharmacy Comments
Contract Details
Approval Date
1/4/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Suzanne Sheridan, Chief Executive Officer
(540) 464-8700 Ext: 7111
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/4/2023
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