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WAL-MART PHARMACY 10-0273
CH04686H Access Family Health Services, Inc.
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Covered Entity Details
Entity Name
Access Family Health Services, Inc.
Subdivision Name
Access School Health-South Pontotoc
Type
HRSA-Funded Health Center
340B ID
CH04686H
Entity Address
1523 S Pontotoc Rd
Pontotoc, MS 38863-9382
Grant Number
H80CS00633
Participating Start Date
10/1/2018
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0273
Pharmacy Address
100 INTERCHANGE DRIVE
FULTON, MS 38843
Pharmacy Comments
Contract Details
Approval Date
5/2/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARILYN SUMERFORD, CEO
(662) 651-4686 Ext: 8103
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
5/2/2023
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