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WAL-MART PHARMACY 10-1033
CHC35351-00 WELL CARE COMMUNITY HEALTH, INC.
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Covered Entity Details
Entity Name
WELL CARE COMMUNITY HEALTH, INC.
Subdivision Name
Well Care Community Health, Inc.
Type
HRSA-Funded Health Center
340B ID
CHC35351-00
Entity Address
203 E Main St
Richmond, IN 47374-4208
Grant Number
H80CS35351
Participating Start Date
10/1/2020
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1033
Pharmacy Address
1600 E TIPTON ST
SEYMOUR, IN 47274
Pharmacy Comments
Contract Details
Approval Date
10/3/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Eric Coulter, Chief Executive Officer
(765) 973-9369
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/3/2023
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