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WALMART PHARMACY 10-5169
CH072130 NORTHWEST HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
NORTHWEST HEALTH SERVICES, INC.
Subdivision Name
FAMILY MEDICINE ASSOCIATES
Type
HRSA-Funded Health Center
340B ID
CH072130
Entity Address
2303 Village Dr
Saint Joseph, MO 64506-4954
Grant Number
H80CS00671
Participating Start Date
10/1/1997
Last Recertification Date
2/19/2025
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
4/5/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Matt Younger, CEO
(816) 307-5303
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/5/2023
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