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WALMART PHARMACY 10-5169
CH071370 SOUTHEAST MISSOURI HEALTH NETWORK
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Covered Entity Details
Entity Name
SOUTHEAST MISSOURI HEALTH NETWORK
Subdivision Name
SOUTHEAST MISSOURI HEALTH NETWORK
Type
HRSA-Funded Health Center
340B ID
CH071370
Entity Address
420 SEMO DR
NEW MADRID, MO 63869-1734
Grant Number
H80CS00557
Participating Start Date
1/1/2005
Last Recertification Date
2/24/2025
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
1/16/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
CHRIS JONES, CEO
(573) 313-2501
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/16/2023
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