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WAL-MART PHARMACY 10-1549
CHC12845-00 NATIVE HEALTH
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Covered Entity Details
Entity Name
NATIVE HEALTH
Subdivision Name
NATIVE HEALTH West 8800
Type
HRSA-Funded Health Center
340B ID
CHC12845-00
Entity Address
8800 N 22nd Ave
Phoenix, AZ 85021
Grant Number
H80CS12845
Participating Start Date
4/1/2012
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1549
Pharmacy Address
2020 N 75TH AVE SUITE 1
PHOENIX, AZ 85035
Pharmacy Comments
06/20/2012 added address line 2, zip2
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Walter Murillo, Chief Executive Officer
(602) 279-5262
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/15/2024
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