340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
CH010060 FAIR HAVEN COMMUNITY HEALTH CLINIC INC
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Covered Entity Details
Entity Name
FAIR HAVEN COMMUNITY HEALTH CLINIC INC
Subdivision Name
FAIR HAVEN COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH010060
Entity Address
374 Grand Ave
New Haven, CT 06513-3733
Grant Number
H80CS00741
Participating Start Date
7/1/2003
Last Recertification Date
2/15/2025
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
SUZANNE LAGARDE, CEO
(203) 752-5129
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/11/2023
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