340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Walmart Pharmacy 10-7611
FQHC638492A Cow Creek Band of Umpqua Tribe Indians
Print
Covered Entity Details
Entity Name
Cow Creek Band of Umpqua Tribe Indians
Subdivision Name
Cow Creek Health & Wellness Center
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638492A
Entity Address
2589 NW Edenbower Blvd
Roseburg, OR 97471
Grant Number
Participating Start Date
7/1/2019
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/14/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sharon Arlene Stanphill, Health Operations Officer
(541) 672-8533 Ext: 5517
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/14/2023
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