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WALMART PHARMACY 10-5169
FQHCLA399 MULTI-CULTURAL HEALTH EVALUATION DELIVERY SYSTEM, INC.
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Covered Entity Details
Entity Name
MULTI-CULTURAL HEALTH EVALUATION DELIVERY SYSTEM, INC.
Subdivision Name
MHEDS Peach Street Site
Type
Health Center Program Look-Alike
340B ID
FQHCLA399
Entity Address
2928 PEACH ST
ERIE, PA 16508
Grant Number
LALCS32712
Participating Start Date
1/1/2020
Last Recertification Date
2/18/2025
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
Contacts
Covered Entity Signing Official
Patricia J Stubber, CEO
(814) 453-6229
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/6/2023
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