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WALMART PHARMACY 10-5169
CH0423590 Tandem Health SC
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Covered Entity Details
Entity Name
Tandem Health SC
Subdivision Name
Tandem Health
Type
HRSA-Funded Health Center
340B ID
CH0423590
Entity Address
1278 North Lafayette Drive
Sumter, SC 29150-2964
Grant Number
H80CS00868
Participating Start Date
1/1/2004
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
Annie Brown, CEO
(803) 774-4500 Ext: 545
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/10/2023
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