340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALMART PHARMACY 10-5169
FQHCLA384 Southwest Georgia Healthcare Clinics, Inc.
Print
Covered Entity Details
Entity Name
Southwest Georgia Healthcare Clinics, Inc.
Subdivision Name
Southwest Georgia Pediatric CLinic
Type
Health Center Program Look-Alike
340B ID
FQHCLA384
Entity Address
205 Bresee Street
Donalsonville, GA 39845-1134
Grant Number
LALCS32518
Participating Start Date
7/1/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
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
Donna L Williams, CEO
(229) 220-1077
Contract Pharmacy Representative
Walmart
Van Donn, Director of Contracting 340b
(303) 261-5549
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