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WALMART PHARMACY 10-5169
CH084100 HIGH PLAINS COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
HIGH PLAINS COMMUNITY HEALTH CENTER
Subdivision Name
HIGH PLAINS COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH084100
Entity Address
201 Kendall Dr
Lamar, CO 81052-3939
Grant Number
H80CS00214
Participating Start Date
7/1/1997
Last Recertification Date
2/25/2025
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
1/11/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
shae lynne emick, Chief Operations Officer
(719) 336-0261 Ext: 1146
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/11/2023
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