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WALMART PHARMACY 10-5169
CH024490 NORTH HUDSON COMMUNITY ACTION CORPORATION
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Covered Entity Details
Entity Name
NORTH HUDSON COMMUNITY ACTION CORPORATION
Subdivision Name
North Hudson Community Action Corporation @ West New York
Type
HRSA-Funded Health Center
340B ID
CH024490
Entity Address
5301 BROADWAY
WEST NEW YORK, NJ 07093-2622
Grant Number
H80CS00521
Participating Start Date
1/1/2004
Last Recertification Date
2/10/2025
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
Contract Termination Date
Termination Reason
1/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Rebecca Acosta, Executive Vice President
(201) 210-0100 Ext: 10102
Contract Pharmacy Representative
Walmart
Julie Howard, 340b Program Manager
(479) 739-1973 Ext: 4792771498
Signed By Date
1/17/2023
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