Contract Pharmacy Details

WALMART PHARMACY 10-5169
CHC39465-04 CATHERINE'S HEALTH CENTER

Covered Entity Details

Entity Name

CATHERINE'S HEALTH CENTER

Subdivision Name

Catherines Health Center Townline

Type

HRSA-Funded Health Center

340B ID

CHC39465-04

Entity Address

100 60th St., SE RM E3 Ste A
Grand Rapids, MI 49548

Grant Number

H80CS39465

Participating Start Date

10/1/2023

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

340B Drug Pricing Program Database