340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALMART PHARMACY 10-5169
CH0611930 KIAMICHI FAMILY MEDICAL CENTER
Print
Covered Entity Details
Entity Name
KIAMICHI FAMILY MEDICAL CENTER
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH0611930
Entity Address
6026 BATTIEST PICKENS RD
BROKEN BOW, OK 74728-5037
Grant Number
H80CS00267
Participating Start Date
1/1/2003
Last Recertification Date
2/10/2025
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
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Amy Gilbreath, CEO
(580) 286-6688
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/13/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session