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WALMART PHARMACY 10-5169
CH0819780 NORTHWEST COLORADO VISTING NURSES ASSOCIATION
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Covered Entity Details
Entity Name
NORTHWEST COLORADO VISTING NURSES ASSOCIATION
Subdivision Name
Northwest Colorado Health Community Health Center - Moffat County
Type
HRSA-Funded Health Center
340B ID
CH0819780
Entity Address
745 Russell Street
Craig, CO 81625-9998
Grant Number
H80CS10610
Participating Start Date
10/14/2008
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
1/19/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/16/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Stephanie Einfeld, Chief Executive Officer
(970) 871-7625
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/19/2023
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