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Walmart Pharmacy 10-7611
CHC11353-00 SPRINGFIELD MEDICAL CARE SYSTEMS INC
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Covered Entity Details
Entity Name
SPRINGFIELD MEDICAL CARE SYSTEMS INC
Subdivision Name
Ludlow Health Center
Type
HRSA-Funded Health Center
340B ID
CHC11353-00
Entity Address
1 Elm St.
Ludlow, VT 05149-1301
Grant Number
H80CS12873
Participating Start Date
1/1/2010
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
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
Joshua Dufresne, CEO
(802) 886-8961
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/5/2024
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