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WAL-MART PHARMACY 10-5389
CH068160 HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
HEART OF TEXAS COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Waco Family Medicine - Central
Type
HRSA-Funded Health Center
340B ID
CH068160
Entity Address
1600 PROVIDENCE DR
WACO, TX 76707-2261
Grant Number
H80CS00719
Participating Start Date
1/1/2000
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5389
Pharmacy Address
600 HEWITT DR
WACO(WOODWAY), TX 76712
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Matthew Robert Polk, Chief Operating Officer
(254) 313-4412
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/16/2023
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