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WALMART PHARMACY 10-5169
CHC26578-00 WOOD, COUNTY OF
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Covered Entity Details
Entity Name
WOOD, COUNTY OF
Subdivision Name
Wood County Community Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26578-00
Entity Address
1840 E Gypsy Lane Rd
Bowling Green, OH 43402-9173
Grant Number
H80CS26578
Participating Start Date
4/1/2014
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
Pharmacy Comments
Contract Details
Approval Date
4/3/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Diane Krill, COO
(419) 354-4203
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/3/2024
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