Contract Pharmacy Details

WALMART PHARMACY 10-5169
CHC02456-00 WINDROSE HEALTH NETWORK, INC.

Covered Entity Details

Entity Name

WINDROSE HEALTH NETWORK, INC.

Subdivision Name

Windrose Health Network - Trafalgar

Type

HRSA-Funded Health Center

340B ID

CHC02456-00

Entity Address

14 Trafalgar Sq
Trafalgar, IN 46181-9515

Grant Number

H80CS02456

Participating Start Date

10/1/2016

Last Recertification Date

2/11/2025

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

4/4/2023

Contract Begin Date

7/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/31/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Scott K Rollett, CEO
(317) 739-4895 Ext: 2401

Contract Pharmacy Representative

Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498

Signed By Date

4/4/2023

340B Drug Pricing Program Database