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WAL-MART PHARMACY 10-5851
CH0428200 METROPOLITAN COMMUNITY HEALTH
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Covered Entity Details
Entity Name
METROPOLITAN COMMUNITY HEALTH
Subdivision Name
AGAPE COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH0428200
Entity Address
120 W Martin Luther King Jr Dr
Washington, NC 27889-4906
Grant Number
H80CS00864
Participating Start Date
10/1/2003
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5851
Pharmacy Address
4600 E. 10TH STREET
GREENVILLE, NC 27858
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Lovell McDuffie, CEO
(252) 644-7002
Contract Pharmacy Representative
Metropolitan Community Health Services
Frank K Debrah, Chief Pharmacy Director
(252) 789-0401
Signed By Date
4/15/2024
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