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WALMART PHARMACY 10-5169
CH013970 RICHFORD HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
RICHFORD HEALTH CENTER, INC.
Subdivision Name
Richford Health Center
Type
HRSA-Funded Health Center
340B ID
CH013970
Entity Address
44 Main Street
Richford, VT 05476-1153
Grant Number
H80CS00261
Participating Start Date
1/1/2003
Last Recertification Date
2/12/2025
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
KATHY J BENOIT, Executive Director
(802) 255-5562 Ext: 562
Contract Pharmacy Representative
Walmart
Van Donn, 340B Director Contracting
(479) 273-4000
Signed By Date
10/4/2023
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