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WAL-MART PHARMACY 10-4635
CH0413090 Cherokee Health Systems
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Covered Entity Details
Entity Name
Cherokee Health Systems
Subdivision Name
CHS Talbott Clinic
Type
HRSA-Funded Health Center
340B ID
CH0413090
Entity Address
6350 W Andrew Johnson Hwy
Talbott, TN 37877
Grant Number
H80CS00309
Participating Start Date
7/1/2005
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-4635
Pharmacy Address
150 TANNER LANE
CLINTON, TN 37716
Pharmacy Comments
Contract Details
Approval Date
7/17/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Suzanne Bailey, Chief Operating Officer
(865) 544-0406
Contract Pharmacy Representative
Walmart
Van Donn, Director of Contracting 340b
(303) 261-5549
Signed By Date
7/17/2023
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