Contract Pharmacy Details

Walmart Pharmacy 10-7611
CH047000 HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.

Covered Entity Details

Entity Name

HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.

Subdivision Name

Health Care Partners of South Carolina, Inc. - Conway Administrative Office

Type

HRSA-Funded Health Center

340B ID

CH047000

Entity Address

1708 Oak Street
Conway, SC 29526-3086

Grant Number

H80CS00411

Participating Start Date

12/1/1992

Last Recertification Date

2/18/2025

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

Contract Termination Date
Termination Reason

6/1/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Santina Mayo, Chief Executive Officer
(843) 488-6034

Contract Pharmacy Representative

Health Care Partners of South Carolina, Inc. - Conway Office Pharmacy
Joseph Hamilton Odom, Director of Pharmacy
(843) 438-8399

Signed By Date

10/16/2023

340B Drug Pricing Program Database