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WALMART PHARMACY 10-5169
CH037460 VALLEY HEALTH CARE, INC
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Covered Entity Details
Entity Name
VALLEY HEALTH CARE, INC
Subdivision Name
VALLEY HEALTH CARE, INC.
Type
HRSA-Funded Health Center
340B ID
CH037460
Entity Address
46 Town Center PLZ STE A
MILL CREEK, WV 26280-9752
Grant Number
H80CS00583
Participating Start Date
9/9/2005
Last Recertification Date
2/26/2025
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
4/12/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jordan A. Godwin, CEO
(304) 335-2050 Ext: 101
Contract Pharmacy Representative
Valley Health Care
Jordan A. Godwin, CEO
(304) 335-2050 Ext: 101
Signed By Date
4/12/2023
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