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WALMART PHARMACY 10-5169
CHC39465-02 CATHERINE'S HEALTH CENTER
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Covered Entity Details
Entity Name
CATHERINE'S HEALTH CENTER
Subdivision Name
Catherine&s Health Center at Streams of Hope
Type
HRSA-Funded Health Center
340B ID
CHC39465-02
Entity Address
280 60th St SE Ste 200
Grand Rapids, MI 49548-8504
Grant Number
H80CS39465
Participating Start Date
4/1/2022
Last Recertification Date
2/13/2025
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
10/9/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sara R Brooks, Director of Operations
(616) 336-8800
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/9/2023
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