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WALMART PHARMACY 10-5169
CH011580 LAMPREY HEALTH CARE
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Covered Entity Details
Entity Name
LAMPREY HEALTH CARE
Subdivision Name
LAMPREY HEALTH CARE
Type
HRSA-Funded Health Center
340B ID
CH011580
Entity Address
207 S MAIN ST.
NEWMARKET, NH 03857
Grant Number
H80CS00640
Participating Start Date
12/1/1992
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
1/6/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Gregory White, CEO
(603) 659-2494 Ext: 7214
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/6/2023
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