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WALMART PHARMACY 10-5169
CHC26598-00 Maury Regional Hospital
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Covered Entity Details
Entity Name
Maury Regional Hospital
Subdivision Name
Lewis Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26598-00
Entity Address
617 W Main St
Hohenwald, TN 38462-1355
Grant Number
H80CS26598
Participating Start Date
10/1/2014
Last Recertification Date
2/12/2025
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
5/4/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Martin Chaney, Chief Executive Officer
(931) 380-4008
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
5/4/2023
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