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WALMART PHARMACY 10-5169
CH0612740 NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS, INC.
Subdivision Name
NE OK COMMUNITY HLTH CENTERS
Type
HRSA-Funded Health Center
340B ID
CH0612740
Entity Address
124 E Main St
Hulbert, OK 74441-8902
Grant Number
H80CS00848
Participating Start Date
1/1/2004
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
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
Crystal Steed, Chief Operations Officer
(918) 772-3390
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/12/2023
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