340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-5189
CH09307N Mountain Park Health Center
Print
Covered Entity Details
Entity Name
Mountain Park Health Center
Subdivision Name
Mountain Park Health Center - Goodyear Suite 106
Type
HRSA-Funded Health Center
340B ID
CH09307N
Entity Address
140 N Litchfield Rd Ste 106
Goodyear, AZ 85338-1226
Grant Number
H80CS00141
Participating Start Date
4/1/2020
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5189
Pharmacy Address
5250 WEST INDIAN SCHOOL RD
PHOENIX (MARYVALE), AZ 85031
Pharmacy Comments
Contract Details
Approval Date
4/12/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John R. Swagert, CEO
(602) 323-3470
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/12/2024
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