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Walmart Pharmacy 10-7611
CHC26562-01 Heartland Health Center, Inc.
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Covered Entity Details
Entity Name
Heartland Health Center, Inc.
Subdivision Name
Heartland Health Center - Grand Island
Type
HRSA-Funded Health Center
340B ID
CHC26562-01
Entity Address
2116 W Faidley Ave Ste 2100
Grand Island, NE 68803
Grant Number
H80CS26562
Participating Start Date
4/1/2020
Last Recertification Date
2/18/2025
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
Tami Smith, CEO
(308) 675-4223
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/12/2023
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