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WALMART PHARMACY 10-5169
CHC35351-03 WELL CARE COMMUNITY HEALTH INC
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Covered Entity Details
Entity Name
WELL CARE COMMUNITY HEALTH INC
Subdivision Name
Well Care Community Health-Foundations Family Medicine Henryville
Type
HRSA-Funded Health Center
340B ID
CHC35351-03
Entity Address
314 S Ferguson St
Henryville, IN 47126-9734
Grant Number
H80CS35351
Participating Start Date
4/7/2023
Last Recertification Date
2/10/2025
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
6/21/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Eric Coulter, Chief Executive Officer
(765) 973-9369
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
6/21/2023
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