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WAL-MART PHARMACY 10-1153
CH045211F FIRST CHOICE PRIMARY CARE, INC.
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Covered Entity Details
Entity Name
FIRST CHOICE PRIMARY CARE, INC.
Subdivision Name
FCPC South Macon
Type
HRSA-Funded Health Center
340B ID
CH045211F
Entity Address
3061 Houston Ave.
Macon, GA 31206
Grant Number
H80CS08242
Participating Start Date
1/1/2018
Last Recertification Date
2/23/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1153
Pharmacy Address
6020 HARRISON ROAD
MACON, GA 31206
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
Katherine McLeod, CEO
(478) 254-7204
Contract Pharmacy Representative
Walmart
Julie Howard, 340b Program Manager
(479) 739-1973 Ext: 4792771498
Signed By Date
10/16/2023
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