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WALMART PHARMACY 10-5169
CHC08769-00 PINES HEALTH SERVICES
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Covered Entity Details
Entity Name
PINES HEALTH SERVICES
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CHC08769-00
Entity Address
74 ACCESS HIGHWAY
CARIBOU, ME 04736
Grant Number
H80CS08769
Participating Start Date
4/1/2009
Last Recertification Date
2/11/2025
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
1/13/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kris Doody, CEO
(207) 498-2356
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/13/2023
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