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WALMART PHARMACY 10-5169
CHC33884-01 PureView Health Center
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Covered Entity Details
Entity Name
PureView Health Center
Subdivision Name
PUREVIEW HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CHC33884-01
Entity Address
1930 9th Ave
Helena, MT 59601-4759
Grant Number
H80CS33884
Participating Start Date
4/1/2020
Last Recertification Date
3/3/2025
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
Jill-Marie Steeley, CEO
(406) 500-2050
Contract Pharmacy Representative
PureView Health Center
Michelle Marten, Pharmacy Director
(406) 500-2080
Signed By Date
1/4/2023
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