Contract Pharmacy Details

WALMART PHARMACY 10-5169
CH090080 MARANA HEALTH CENTER, INC.

Covered Entity Details

Entity Name

MARANA HEALTH CENTER, INC.

Subdivision Name

Marana Health Center, Inc.

Type

HRSA-Funded Health Center

340B ID

CH090080

Entity Address

13395 N. Marana Main Street
MARANA, AZ 85653

Grant Number

H80CS00231

Participating Start Date

7/1/1999

Last Recertification Date

2/10/2025

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

4/17/2023

Contract Begin Date

7/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Tamie Olson, Chief Financial Officer
(520) 682-4111 Ext: 6221

Contract Pharmacy Representative

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

Signed By Date

4/17/2023

340B Drug Pricing Program Database