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Walmart Pharmacy 10-7611
CHC29021-00 FAMILY HEALTH CARE OF NORTHWEST OHIO, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH CARE OF NORTHWEST OHIO, INC.
Subdivision Name
Family Health Care of Northwest Ohio, Inc.
Type
HRSA-Funded Health Center
340B ID
CHC29021-00
Entity Address
1191 Westwood Drive
Van Wert, OH 45891
Grant Number
H80CS29021
Participating Start Date
4/1/2016
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
1/9/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jennifer L Smith, CEO
(419) 238-6747 Ext: 103
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/9/2024
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