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WALMART PHARMACY 10-5169
CH030990 MONROE CO. HEALTH CENTER
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Covered Entity Details
Entity Name
MONROE CO. HEALTH CENTER
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH030990
Entity Address
200 HEALTH CENTER DRIVE
UNION, WV 24983
Grant Number
H80CS00384
Participating Start Date
4/1/2004
Last Recertification Date
2/19/2025
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
1/9/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jim Nelson, CEO
(304) 772-3064 Ext: 129
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/9/2023
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