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WAL-MART PHARMACY 10-0001
CH061950T St. Francis House NWA, Inc.
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Covered Entity Details
Entity Name
St. Francis House NWA, Inc.
Subdivision Name
Community Clinic Pea Ridge
Type
HRSA-Funded Health Center
340B ID
CH061950T
Entity Address
1923 W Pickens Rd
Pea Ridge, AR 72751-2504
Grant Number
H80CS04290
Participating Start Date
1/1/2021
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0001
Pharmacy Address
2110 WEST WALNUT
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
James Semingson II, Chief Executive Officer
(479) 751-7417 Ext: 6070
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/16/2023
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