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Walmart Pharmacy 10-7611
CH046560 HARDIN COUNTY REGIONAL HEALTH CENTER
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Covered Entity Details
Entity Name
HARDIN COUNTY REGIONAL HEALTH CENTER
Subdivision Name
DBA LIfespan Health
Type
HRSA-Funded Health Center
340B ID
CH046560
Entity Address
765 FLORENCE ROAD
SAVANNAH, TN 38372
Grant Number
H80CS00180
Participating Start Date
7/1/2003
Last Recertification Date
2/26/2025
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
Y. T. McGinley, CEO
(731) 925-2300 Ext: 8968
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/12/2023
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