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Walmart Pharmacy 10-7611
CH033230 TRI-AREA COMMUNITY HEALTH
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Covered Entity Details
Entity Name
TRI-AREA COMMUNITY HEALTH
Subdivision Name
Tri-Area Community Health Center at Laurel Fork
Type
HRSA-Funded Health Center
340B ID
CH033230
Entity Address
14558 DANVILLE PIKE
LAUREL FORK, VA 24352-0009
Grant Number
H80CS00446
Participating Start Date
7/1/1995
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
4/6/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James L. Werth, Jr., CEO
(276) 870-3008
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/6/2024
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