340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALMART PHARMACY 10-5169
HV00133 JEFFERSON COMPREHENSIVE CARE SYSTEM INC
Print
Covered Entity Details
Entity Name
JEFFERSON COMPREHENSIVE CARE SYSTEM INC
Subdivision Name
PINE BLUFF MEDICAL & DENTAL CENTER
Type
Ryan White Part C
340B ID
HV00133
Entity Address
1101 S TENNESSEE STREET
PINE BLUFF, AR 71601
Grant Number
H76HA00133
Participating Start Date
1/1/2007
Last Recertification Date
3/7/2025
Entity Termination Date
4/1/2025
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
4/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Sandra J. Brown, Chief Executive Officer
(870) 543-2300
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/17/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session