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WAL-MART PHARMACY 10-0366
CH044251D CHOTA COMMUNITY HEALTH SERVICES
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Covered Entity Details
Entity Name
CHOTA COMMUNITY HEALTH SERVICES
Subdivision Name
TELLICO PLAINS ELEMENTARY SCHOOL
Type
HRSA-Funded Health Center
340B ID
CH044251D
Entity Address
121 OLD HIGH SCHOOL Road
TELLICO PLAINS, TN 37385-4965
Grant Number
H80CS06461
Participating Start Date
1/1/2014
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0366
Pharmacy Address
4525 HWY 411
MADISONVILLE, TN 37354
Pharmacy Comments
Contract Details
Approval Date
3/10/2023
Contract Begin Date
3/10/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Laura Harris, CEO
(423) 442-7268
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
3/10/2023
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