Contract Pharmacy Details

WALMART PHARMACY 10-5169
CHC28361-00 SUMMIT COMMUNITY CARE CLINIC

Covered Entity Details

Entity Name

SUMMIT COMMUNITY CARE CLINIC

Subdivision Name

Summit Community Care Clinic, Inc.

Type

HRSA-Funded Health Center

340B ID

CHC28361-00

Entity Address

360 Peak One Drive STE 100
Frisco, CO 80443

Grant Number

H80CS28361

Participating Start Date

10/1/2015

Last Recertification Date

2/11/2025

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

10/4/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Susan Robertson, Interim Chief Executive Officer
(970) 822-8616

Contract Pharmacy Representative

Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498

Signed By Date

10/4/2023

340B Drug Pricing Program Database