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Walmart Pharmacy 10-7611
CHC26610-00 HI-DESERT MEMORIAL HEALTH CARE DISTRICT
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Covered Entity Details
Entity Name
HI-DESERT MEMORIAL HEALTH CARE DISTRICT
Subdivision Name
Morongo Basin Community Health Center-SR
Type
HRSA-Funded Health Center
340B ID
CHC26610-00
Entity Address
6380 Split Rock Ave
Twentynine Palms, CA 92277
Grant Number
H80CS26610
Participating Start Date
7/1/2015
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
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
Cindy Schmall, Chief Executive Officer
(760) 820-9229 Ext: 1907
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/16/2023
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