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WALMART PHARMACY 10-5169
CH042160 DAYSPRING HEALTH, INC.
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Covered Entity Details
Entity Name
DAYSPRING HEALTH, INC.
Subdivision Name
DAYSPRING HEALTH, INC.
Type
HRSA-Funded Health Center
340B ID
CH042160
Entity Address
107 S Main St
Jellico, TN 37762-2154
Grant Number
H80CS00716
Participating Start Date
10/1/1996
Last Recertification Date
2/10/2025
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
Lawrence Michael Rector, CEO
(423) 784-8492 Ext: 221
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/6/2023
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