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WAL-MART PHARMACY 10-2225
CH01182J THUNDERMIST HEALTH CENTER
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Covered Entity Details
Entity Name
THUNDERMIST HEALTH CENTER
Subdivision Name
THUNDERMIST SOUTH COUNTY
Type
HRSA-Funded Health Center
340B ID
CH01182J
Entity Address
1 River St
Wakefield, RI 02879-3214
Grant Number
H80CS00454
Participating Start Date
7/1/2007
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2225
Pharmacy Address
7 DOWLING VILLAGE BLVD
NORTH SMITHFIELD, RI 02896
Pharmacy Comments
Contract Details
Approval Date
1/12/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Charles T. Jones, President/CEO
(401) 767-4100 Ext: 3176
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
1/12/2014
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