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WALMART PHARMACY 10-5169
CH092060 WAIKIKI HEALTH
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Covered Entity Details
Entity Name
WAIKIKI HEALTH
Subdivision Name
Waikiki Health Ohua
Type
HRSA-Funded Health Center
340B ID
CH092060
Entity Address
277 Ohua Ave
Honolulu, HI 96815-3643
Grant Number
H80CS00053
Participating Start Date
4/1/2004
Last Recertification Date
2/13/2025
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
Phyllis Dendle, CEO
(808) 537-8443
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/11/2023
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