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WAL-MART PHARMACY 10-0002
CH06373E BOSTON MOUNTAIN RURAL HEALTH CENTER, INC
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Covered Entity Details
Entity Name
BOSTON MOUNTAIN RURAL HEALTH CENTER, INC
Subdivision Name
BOSTON MOUNTAIN RURAL HLTH CTR
Type
HRSA-Funded Health Center
340B ID
CH06373E
Entity Address
HC 31 Box 310
DEER, AR 72628
Grant Number
H80CS00641
Participating Start Date
4/1/2006
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0002
Pharmacy Address
161 N WALMART DRIVE
HARRISON, AR 72601
Pharmacy Comments
Contract Details
Approval Date
10/11/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Becky Blair, CFO
(870) 448-5733 Ext: 2008
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/11/2023
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