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WALMART PHARMACY 10-3614
CH037480 KUUMBA COMMUNITY HEALTH & WELLNESS CENTER, INC.
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Covered Entity Details
Entity Name
KUUMBA COMMUNITY HEALTH & WELLNESS CENTER, INC.
Subdivision Name
Kuumba Community Health and Wellness Center, Inc. d/b/a New Horizons Healthcare
Type
HRSA-Funded Health Center
340B ID
CH037480
Entity Address
3716 Melrose Avenue NW
Roanoke, VA 24017-2716
Grant Number
H80CS00608
Participating Start Date
1/1/2001
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-3614
Pharmacy Address
2141 DALE AVE
ROANOKE, VA 24013
Pharmacy Comments
Contract Details
Approval Date
4/5/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jonathan Stewart, Chief Executive Officer
(540) 362-0360 Ext: 101
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
4/5/2024
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