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WALMART PHARMACY 10-5169
FQHCLA350 COMMUNITY ACCESS NETWORK, INC.
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Covered Entity Details
Entity Name
COMMUNITY ACCESS NETWORK, INC.
Subdivision Name
Park View
Type
Health Center Program Look-Alike
340B ID
FQHCLA350
Entity Address
2420 Memorial Ave
Lynchburg, VA 24501
Grant Number
LALCS31106
Participating Start Date
10/1/2017
Last Recertification Date
2/12/2025
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
1/15/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christina Delzingaro, CEO
(434) 200-3366
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/15/2023
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