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Walmart Pharmacy 10-7611
CH048950 SE ALABAMA RURAL HEALTH ASSOCIATES (SARHA)
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Covered Entity Details
Entity Name
SE ALABAMA RURAL HEALTH ASSOCIATES (SARHA)
Subdivision Name
Administrative Offices
Type
HRSA-Funded Health Center
340B ID
CH048950
Entity Address
1414 Elba Hwy
Troy, AL 36079-6020
Grant Number
H80CS00376
Participating Start Date
7/1/1996
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
10/5/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Pamylon Bowers, Chief Executive Officer
(334) 670-6726 Ext: 173
Contract Pharmacy Representative
Walmart
George Flaherty, Senior Director Payer Programs
(479) 204-9374
Signed By Date
10/5/2023
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