340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-4272
CH100180 HEALTH WEST INC
Print
Covered Entity Details
Entity Name
HEALTH WEST INC
Subdivision Name
HEALTH WEST - ADMINISTRATION OFFICES
Type
HRSA-Funded Health Center
340B ID
CH100180
Entity Address
500 S 11th AVE
POCATELLO, ID 83201-4835
Grant Number
H80CS00321
Participating Start Date
4/1/2004
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-4272
Pharmacy Address
1150 S 100 W
LOGAN, UT 84321
Pharmacy Comments
Contract Details
Approval Date
4/4/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mark T Horrocks, Chief Medical Officer
(208) 232-7862
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/4/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session