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WALMART PHARMACY 10-5169
CH047430 GEORGIA HIGHLANDS MEDICAL SERVICES, INC.
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Covered Entity Details
Entity Name
GEORGIA HIGHLANDS MEDICAL SERVICES, INC.
Subdivision Name
GHMS Cumming Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH047430
Entity Address
260 Elm St
Cumming, GA 30040-2467
Grant Number
H80CS00470
Participating Start Date
1/1/2005
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
4/10/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Todd Shifflet, CEO
(770) 887-1668 Ext: 1102
Contract Pharmacy Representative
Walmart
Julie Howard, 340b Program Manager
(479) 739-1973 Ext: 4792771498
Signed By Date
4/10/2023
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