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WAL-MART PHARMACY 10-4678
CH081849C SOUTHWEST UTAH COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
SOUTHWEST UTAH COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Hurricane Utah School Based Clinic
Type
HRSA-Funded Health Center
340B ID
CH081849C
Entity Address
391 N 200 W
Hurricane, UT 84737-1616
Grant Number
H80CS07890
Participating Start Date
10/1/2014
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-4678
Pharmacy Address
180 NORTH 3400 WEST
HURRICANE, UT 84737
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
Lori Wright, CEO
(435) 879-5101
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/11/2023
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