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Walmart Pharmacy 10-7611
CH05166D IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION
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Covered Entity Details
Entity Name
IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION
Subdivision Name
Ironton Health Care Campus
Type
HRSA-Funded Health Center
340B ID
CH05166D
Entity Address
1408 Campbell Dr
Ironton, OH 45638-2301
Grant Number
H80CS00471
Participating Start Date
4/1/2012
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
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kelly Adkins, Chief Financial Officer
(740) 532-3534 Ext: 12004
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/12/2023
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