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WAL-MART PHARMACY 10-1758
CH0510700 OPEN DOOR HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
OPEN DOOR HEALTH SERVICES, INC.
Subdivision Name
Open Door Health Services
Type
HRSA-Funded Health Center
340B ID
CH0510700
Entity Address
333 S Madison Street
Suite 79
Muncie, IN 47305
Grant Number
H80CS00340
Participating Start Date
4/1/2001
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1758
Pharmacy Address
3167 S STATE RD #3
NEW CASTLE, IN 47362
Pharmacy Comments
Contract Details
Approval Date
1/5/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bryan Ayars, CEO
(765) 747-2971
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/5/2024
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