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WALMART PHARMACY 10-5169
CH046900 MEDCURA HEALTH, INC.
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Covered Entity Details
Entity Name
MEDCURA HEALTH, INC.
Subdivision Name
STONE MOUNTAIN
Type
HRSA-Funded Health Center
340B ID
CH046900
Entity Address
5582 MEMORIAL DRIVE
STONE MOUNTAIN, GA 30083
Grant Number
H80CS00179
Participating Start Date
4/1/2004
Last Recertification Date
2/16/2025
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
7/14/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/20/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jeff Taylor, Chief Executive Officer
(404) 298-3250
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
7/14/2023
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