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WALMART PHARMACY 10-5169
CHC24177-00 CAHABA MEDICAL CARE FOUNDATION
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Covered Entity Details
Entity Name
CAHABA MEDICAL CARE FOUNDATION
Subdivision Name
Cahaba Medical Care - Centreville Office
Type
HRSA-Funded Health Center
340B ID
CHC24177-00
Entity Address
405 Belcher St
Centreville, AL 35042-2946
Grant Number
H80CS24177
Participating Start Date
1/1/2014
Last Recertification Date
2/12/2025
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
John Waits, CEO
(205) 277-2396
Contract Pharmacy Representative
Walmart
Julie Howard, 340b Program Manager
(479) 739-1973 Ext: 4792771498
Signed By Date
1/17/2023
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