340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALMART PHARMACY 10-5169
CH057440 PCC COMMUNITY WELLNESS CENTER
Print
Covered Entity Details
Entity Name
PCC COMMUNITY WELLNESS CENTER
Subdivision Name
PCC Lake Street Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH057440
Entity Address
14 Lake St
Oak Park, IL 60302-2606
Grant Number
H80CS00276
Participating Start Date
7/1/1997
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
1/10/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Toni Bush, President and CEO
(708) 524-7678
Contract Pharmacy Representative
Walmart
Julie Howard, 340b Program Manager
(479) 739-1973 Ext: 4792771498
Signed By Date
1/10/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session