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Walmart Pharmacy 10-7611
CH086120 COMMUNITY HEALTH CENTER OF CENTRAL WYOMING, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER OF CENTRAL WYOMING, INC.
Subdivision Name
Community Health Center of Central Wyoming
Type
HRSA-Funded Health Center
340B ID
CH086120
Entity Address
5000 Blackmore Road
Casper, WY 82609
Grant Number
H80CS00564
Participating Start Date
1/1/2001
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
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
Kevin Shea Lanham, CEO
(307) 233-6058
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
4/12/2024
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