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Walmart Pharmacy 10-7611
CH091540 OPEN DOOR COMMUNITY HEALTH CENTERS
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Covered Entity Details
Entity Name
OPEN DOOR COMMUNITY HEALTH CENTERS
Subdivision Name
Arcata Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH091540
Entity Address
1150 Foster Avenue
Arcata, CA 95521-6210
Grant Number
H80CS00225
Participating Start Date
7/1/1996
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
Natasha Wood, Chief Financial Officer
(707) 616-6927
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/16/2023
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