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WAL-MART PHARMACY 10-0204
CHC17157-08 Regional Health Care Affiliates, Inc.
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Covered Entity Details
Entity Name
Regional Health Care Affiliates, Inc.
Subdivision Name
Regional Health Care Affiliates, Inc. dba Health First Community Health Center- Princeton
Type
HRSA-Funded Health Center
340B ID
CHC17157-08
Entity Address
1100 S Jefferson Street
Princeton, KY 42445-2379
Grant Number
H80CS17157
Participating Start Date
10/1/2017
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0204
Pharmacy Address
1500 US 62 WEST
PRINCETON, KY 42445
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
Shelley Renea Gobin, CEO
(270) 667-2535 Ext: 2104
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/13/2023
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