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WALMART PHARMACY 10-5169
CH0614350 COMMUNITY ACTION CORPORATION OF SOUTH TEXAS
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Covered Entity Details
Entity Name
COMMUNITY ACTION CORPORATION OF SOUTH TEXAS
Subdivision Name
COMMUNITY ACTION CORPORATION OF SOUTH TEXAS
Type
HRSA-Funded Health Center
340B ID
CH0614350
Entity Address
204 E 1st St
Alice, TX 78332-4822
Grant Number
H80CS02323
Participating Start Date
4/1/2004
Last Recertification Date
2/14/2025
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
1/18/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ann Awalt, CEO
(361) 664-0145 Ext: 2024
Contract Pharmacy Representative
Walmart
Julie Howard, 340b Program Manager
(479) 739-1973 Ext: 4792771498
Signed By Date
1/18/2023
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