Contract Pharmacy Details

Walmart Pharmacy 10-7611
CH052900 COMMUNITY ACTION COMMITTEE OF PIKE COUNTY

Covered Entity Details

Entity Name

COMMUNITY ACTION COMMITTEE OF PIKE COUNTY

Subdivision Name

N/A

Type

HRSA-Funded Health Center

340B ID

CH052900

Entity Address

941 MARKET STREET
PIKETON, OH 45661

Grant Number

H80CS00399

Participating Start Date

12/1/1992

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

Walmart Pharmacy 10-7611

Pharmacy Address

2501 Perry Rd
Plainfield, IN 46168

Pharmacy Comments

Contract Details

Approval Date

10/12/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Keith Pitts, President and Chief Executive Officer
(216) 770-3409 Ext: 7009

Contract Pharmacy Representative

Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498

Signed By Date

10/12/2023

340B Drug Pricing Program Database