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Walmart Pharmacy 10-7611
CH06374L NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER
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Covered Entity Details
Entity Name
NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER
Subdivision Name
Family Health Center on Virginia
Type
HRSA-Funded Health Center
340B ID
CH06374L
Entity Address
1620 W Virginia St
Mckinney, TX 75069-7862
Grant Number
H80CS00553
Participating Start Date
4/1/2021
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
4/10/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Allen Patterson, CEO
(940) 397-2602
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
4/10/2024
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