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Walmart Pharmacy 10-7611
CHC24142-00 HIGH COUNTRY COMMUNITY HEALTH
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Covered Entity Details
Entity Name
HIGH COUNTRY COMMUNITY HEALTH
Subdivision Name
High Country Community Health: Watauga Center
Type
HRSA-Funded Health Center
340B ID
CHC24142-00
Entity Address
935 State Farm Road
Boone, NC 28607
Grant Number
H80CS24142
Participating Start Date
1/1/2013
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
1/19/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alice Salthouse, CEO
(828) 262-3886 Ext: 127
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/19/2024
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