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WAL-MART CENTRAL FILL 10-2670
CH092650 AJO COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
AJO COMMUNITY HEALTH CENTER
Subdivision Name
DESERT SENITA COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH092650
Entity Address
410 N Malacate St
Ajo, AZ 85321-2254
Grant Number
H80CS00753
Participating Start Date
7/1/2000
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART CENTRAL FILL 10-2670
Pharmacy Address
608 SPRING HILL DR # 3 SUITE 300
SPRING, TX 77386
Pharmacy Comments
Contract Details
Approval Date
4/20/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/10/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jonathan Leonard, CEO
(520) 387-5651 Ext: 3007
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/20/2023
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