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Walmart Pharmacy 10-7611
FQHCLA399A MULTI-CULTURAL HEALTH EVALUATION DELIVERY SYSTEM, INC.
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Covered Entity Details
Entity Name
MULTI-CULTURAL HEALTH EVALUATION DELIVERY SYSTEM, INC.
Subdivision Name
MHEDS-John F. Kennedy Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA399A
Entity Address
2021 E 20th St
Erie, PA 16510
Grant Number
LALCS32712
Participating Start Date
1/1/2021
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
10/9/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jessica Hughes, CEO
(814) 453-6229
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/9/2023
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