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Walmart Pharmacy 10-7611
CH010760 Amoskeag Health
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Covered Entity Details
Entity Name
Amoskeag Health
Subdivision Name
Amoskeag Health
Type
HRSA-Funded Health Center
340B ID
CH010760
Entity Address
145 Hollis St
Manchester, NH 03101-1235
Grant Number
H80CS00571
Participating Start Date
4/1/1996
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/4/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kris McCracken, President/CEO
(603) 935-5210
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
10/4/2023
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