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WALMART PHARMACY 10-5169
CH072110 Charles Drew Health Center, Inc
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Covered Entity Details
Entity Name
Charles Drew Health Center, Inc
Subdivision Name
Charles Drew Health Center, Inc.
Type
HRSA-Funded Health Center
340B ID
CH072110
Entity Address
2915 Grant St
Omaha, NE 68111-3863
Grant Number
H80CS00438
Participating Start Date
4/1/1996
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
Contacts
Covered Entity Signing Official
Kenny D. McMorris, Chief Executive Officer
(402) 457-1245
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/17/2023
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