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WALMART PHARMACY 10-5169
CH032700 KEYSTONE RURAL HEALTH CENTER
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Covered Entity Details
Entity Name
KEYSTONE RURAL HEALTH CENTER
Subdivision Name
ADMINISTRATION
Type
HRSA-Funded Health Center
340B ID
CH032700
Entity Address
111 Chambers Hill Drive, Suite 200
CHAMBERSBURG, PA 17201
Grant Number
H80CS00076
Participating Start Date
1/1/2000
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
7/10/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JOANNE COCHRAN, PRESIDENT AND CEO
(717) 709-7906
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/10/2023
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