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WALMART PHARMACY 10-5169
CH063740 NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER
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Covered Entity Details
Entity Name
NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER
Subdivision Name
North Central Texas Community Health Care Center
Type
HRSA-Funded Health Center
340B ID
CH063740
Entity Address
200 MARTIN LUTHER KING, JR. BOULEVARD
WICHITA FALLS, TX 76301
Grant Number
H80CS00553
Participating Start Date
10/1/1994
Last Recertification Date
2/11/2025
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
1/17/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Allen Patterson, CEO
(940) 397-2602
Contract Pharmacy Representative
Walmart
Julie Howard, 340b Program Manager
(479) 739-1973 Ext: 4792771498
Signed By Date
1/17/2023
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