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WAL-MART PHARMACY 10-3837
CH059030 COMMUNITY HEALTH SYSTEMS, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH SYSTEMS, INC.
Subdivision Name
Beloit Area Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH059030
Entity Address
74 Eclipse Ctr
BELOIT, WI 53511-3550
Grant Number
H80CS00676
Participating Start Date
1/1/1999
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3837
Pharmacy Address
4781 EAST ROCKTON RD.
ROSCOE, IL 61073
Pharmacy Comments
Contract Details
Approval Date
4/9/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/9/2024
Agreement registered in error
Contacts
Covered Entity Signing Official
Caryn Davis, Director of Finance
(608) 299-3302
Contract Pharmacy Representative
Community Health Systems, Inc.
Angelique Ayers, Specialized Services Coordinator
(608) 299-3303
Signed By Date
4/9/2024
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