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WAL-MART PHARMACY 10-3260
CH101000 MOSES LAKE COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
MOSES LAKE COMMUNITY HEALTH CENTER
Subdivision Name
MOSES LAKE COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH101000
Entity Address
605 S Coolidge St
Moses Lake, WA 98837
Grant Number
H80CS00702
Participating Start Date
1/1/2000
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3260
Pharmacy Address
1399 NAT WASHINGTON WAY
EPHRATA, WA 98823
Pharmacy Comments
Contract Details
Approval Date
1/13/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/17/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Sheila Berschauer, CEO
(509) 765-0674 Ext: 2411
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
1/13/2023
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