340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
CH101310 CLACKAMAS, COUNTY OF
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Covered Entity Details
Entity Name
CLACKAMAS, COUNTY OF
Subdivision Name
Clackamas Health Centers Administration
Type
HRSA-Funded Health Center
340B ID
CH101310
Entity Address
2051 Kaen Road STE 367
Oregon City, OR 97045-4035
Grant Number
H80CS00547
Participating Start Date
4/1/2004
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
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sarah Ann Jacobson, Health Center Administration & Financial Services Manager
(503) 201-1890
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/13/2023
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