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Walmart Pharmacy 10-7611
CH050040 SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORPORATION
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Covered Entity Details
Entity Name
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORPORATION
Subdivision Name
SHAWNEE HEALTH SERVICE AND DEVELOPMENT C
Type
HRSA-Funded Health Center
340B ID
CH050040
Entity Address
109 California St
Carterville, IL 62918-1923
Grant Number
H80CS00667
Participating Start Date
7/1/1998
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
1/1/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christina G Carney, Chief Executive Officer
(618) 985-8221
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/1/2024
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