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Walmart Pharmacy 10-7611
CH04680A PERSON FAMILY MEDICAL CENTER
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Covered Entity Details
Entity Name
PERSON FAMILY MEDICAL CENTER
Subdivision Name
Person Family Dental Center Roxboro Site
Type
HRSA-Funded Health Center
340B ID
CH04680A
Entity Address
706 N Main St
Roxboro, NC 27573-4755
Grant Number
H80CS00483
Participating Start Date
1/1/2020
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
1/10/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JANET Anne WALKER, CFO
(336) 599-2900 Ext: 355
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/10/2024
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