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WAL-MART PHARMACY 10-6960
CH061950L ST. FRANCIS HOUSE NWA, INC.
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Covered Entity Details
Entity Name
ST. FRANCIS HOUSE NWA, INC.
Subdivision Name
Prairie Grove School Based Health Center
Type
HRSA-Funded Health Center
340B ID
CH061950L
Entity Address
801 VINEY GROVE RD
PRAIRIE GROVE, AR 72753-2623
Grant Number
H80CS04290
Participating Start Date
10/1/2014
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-6960
Pharmacy Address
935 S HOLLY STREET
SILOAM SPRINGS, AR 72761
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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