340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
CHC10590-00 Midtown Health Center, Inc.
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Covered Entity Details
Entity Name
Midtown Health Center, Inc.
Subdivision Name
Midtown Health Center, Inc.
Type
HRSA-Funded Health Center
340B ID
CHC10590-00
Entity Address
302 W Phillip Ave
Norfolk, NE 68701-5248
Grant Number
H80CS10590
Participating Start Date
4/1/2010
Last Recertification Date
2/19/2025
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
KATHY NORDBY, Cheif Executive Officer
(402) 370-1060
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/12/2023
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