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Walmart Pharmacy 10-7611
CH0622370 SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
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Covered Entity Details
Entity Name
SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
Subdivision Name
SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER
Type
HRSA-Funded Health Center
340B ID
CH0622370
Entity Address
725 PATE STREET
ALBANY, TX 76430-2435
Grant Number
H80CS06460
Participating Start Date
12/16/2005
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
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
Meagan Marshall, CEO
(325) 762-2447 Ext: 110
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/11/2023
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