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WALMART PHARMACY 10-5169
CH020110 WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.
Subdivision Name
WHITNEY M. YOUNG, JR. HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH020110
Entity Address
920 Lark Dr
Albany, NY 12207-1300
Grant Number
H80CS00433
Participating Start Date
10/1/1995
Last Recertification Date
2/14/2025
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
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Harold Shippee, President & CEO
(518) 591-4459
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/16/2023
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