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WALMART PHARMACY 10-5169
CH098550 HANA HEALTH
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Covered Entity Details
Entity Name
HANA HEALTH
Subdivision Name
HANA COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH098550
Entity Address
4590 HANA HIGHWAY
HANA, HI 96713-0807
Grant Number
H80CS00290
Participating Start Date
4/1/2003
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
1/23/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
CHERYL VASCONCELLOS, CEO
(808) 888-5796
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/23/2023
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