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WALMART PHARMACY 10-5169
CH021240 FAMILY HEALTH NETWORK OF CENTRAL NEW YORK, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH NETWORK OF CENTRAL NEW YORK, INC.
Subdivision Name
FAMILY HEALTH NETWORK OF CENTRAL NEW YORK, INC.
Type
HRSA-Funded Health Center
340B ID
CH021240
Entity Address
85 South West Street
Homer, NY 13077
Grant Number
H80CS00065
Participating Start Date
1/1/1997
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
Kimberly Marie Osborne, Chief Executive Officer
(607) 753-3797
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/16/2023
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