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WAL-MART PHARMACY 10-1136
CH061898C Rkm Primary Care
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Covered Entity Details
Entity Name
Rkm Primary Care
Subdivision Name
WBR PRIMARY CARE
Type
HRSA-Funded Health Center
340B ID
CH061898C
Entity Address
203 Allendale Drive
PORT ALLEN, LA 70767
Grant Number
H80CS06459
Participating Start Date
4/1/2008
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1136
Pharmacy Address
3255 LA HWY 1 SOUTH
PORT ALLEN, LA 70767
Pharmacy Comments
Contract Details
Approval Date
7/13/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christi C. Hunt, CEO
(225) 683-5292 Ext: 10203
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
7/13/2023
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