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WALMART PHARMACY 10-6467
CHC28363-00 SPECIAL HEALTH RESOURCES FOR TEXAS, INCORPORATED
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Covered Entity Details
Entity Name
SPECIAL HEALTH RESOURCES FOR TEXAS, INCORPORATED
Subdivision Name
Longview Care Clinic
Type
HRSA-Funded Health Center
340B ID
CHC28363-00
Entity Address
409 N. 6th Street
LONGVIEW, TX 75601-6511
Grant Number
H80CS28363
Participating Start Date
7/1/2016
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-6467
Pharmacy Address
450 S SOUTHEAST LOOP 323
TYLER, TX 75702-7570
Pharmacy Comments
Contract Details
Approval Date
5/3/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shaun'ta Whitehead, CEO
(903) 212-7395
Contract Pharmacy Representative
Walmart
Julie Howard, 340b Program Manager
(479) 739-1973 Ext: 4792771498
Signed By Date
5/3/2023
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