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Walmart Pharmacy 10-7611
CH0819780 NORTHWEST COLORADO VISTING NURSES ASSOCIATION
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Covered Entity Details
Entity Name
NORTHWEST COLORADO VISTING NURSES ASSOCIATION
Subdivision Name
Northwest Colorado Health Community Health Center - Moffat County
Type
HRSA-Funded Health Center
340B ID
CH0819780
Entity Address
745 Russell Street
Craig, CO 81625-9998
Grant Number
H80CS10610
Participating Start Date
10/14/2008
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
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stephanie Einfeld, Chief Executive Officer
(970) 871-7625
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/16/2024
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