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Walmart Pharmacy 10-7611
CHC24140-00 Southern Tier Community Health Center Network
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Covered Entity Details
Entity Name
Southern Tier Community Health Center Network
Subdivision Name
Southern Tier Community Health Center Network, Olean site
Type
HRSA-Funded Health Center
340B ID
CHC24140-00
Entity Address
135 N. Union St.
Olean, NY 14760-2736
Grant Number
H80CS24140
Participating Start Date
3/1/2013
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/5/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brett Lawton, CEO
(716) 701-6831
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/5/2023
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