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WALMART PHARMACY 10-5169
CH067960 PROJECT VIDA HEALTH CENTER
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Covered Entity Details
Entity Name
PROJECT VIDA HEALTH CENTER
Subdivision Name
PROJECT VIDA HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH067960
Entity Address
3607 Rivera
EL PASO, TX 79905-2415
Grant Number
H80CS04287
Participating Start Date
10/1/2004
Last Recertification Date
2/10/2025
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
Bill Schlesinger, CEO
(915) 465-1191 Ext: 207
Contract Pharmacy Representative
Walmart
Julie Howard, 340b Program Manager
(479) 739-1973 Ext: 4792771498
Signed By Date
1/4/2023
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