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WALMART PHARMACY 10-5169
CHC28357-00 NORTH OLYMPIC HEALTHCARE NETWORK PC
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Covered Entity Details
Entity Name
NORTH OLYMPIC HEALTHCARE NETWORK PC
Subdivision Name
North Olympic Healthcare Network PC
Type
HRSA-Funded Health Center
340B ID
CHC28357-00
Entity Address
240 W FRONT ST
PORT ANGELES, WA 98362-2609
Grant Number
H80CS28357
Participating Start Date
1/1/2016
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
10/6/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Beau Jacob Brown, Chief Financial Officer
(360) 452-7891 Ext: 2828
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/6/2023
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