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WALMART PHARMACY 10-5169
CH021510 Sun River Health, Inc.
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Covered Entity Details
Entity Name
Sun River Health, Inc.
Subdivision Name
Sun River Health Peekskill
Type
HRSA-Funded Health Center
340B ID
CH021510
Entity Address
1037 Main St
Peekskill, NY 10566-2913
Grant Number
H80CS00313
Participating Start Date
12/1/1992
Last Recertification Date
3/5/2025
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
Allison Dubois, COO
(914) 734-8600 Ext: 78503
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
10/16/2023
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