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WAL-MART PHARMACY 10-0311
CH060180 Teche Action Board, The
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Covered Entity Details
Entity Name
Teche Action Board, The
Subdivision Name
TECHE ACTION CLINIC
Type
HRSA-Funded Health Center
340B ID
CH060180
Entity Address
1115 Weber St
Franklin, LA 70538-4124
Grant Number
H80CS00767
Participating Start Date
12/1/1992
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0311
Pharmacy Address
200 NORTHWEST BLVD
FRANKLIN, LA 70538
Pharmacy Comments
Contract Details
Approval Date
7/25/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
William Brent, CFO
(337) 828-2550 Ext: 2146
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/25/2016
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