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WALMART PHARMACY 10-5169
CHC24197-01 Health Services of North Texas, Inc.
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Covered Entity Details
Entity Name
Health Services of North Texas, Inc.
Subdivision Name
HSNT Denton Medical Center 4308
Type
HRSA-Funded Health Center
340B ID
CHC24197-01
Entity Address
4308 Mesa Dr
Denton, TX 76207-3459
Grant Number
H80CS24197
Participating Start Date
10/1/2014
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
4/17/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Doreen Rue, CEO
(940) 381-1501 Ext: 3001
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/17/2023
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