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MAXOR SPECIALTY PHARMACY
CHC26632-01 Whitman-Walker Clinic, Inc.
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Covered Entity Details
Entity Name
Whitman-Walker Clinic, Inc.
Subdivision Name
Max Robinson Center
Type
HRSA-Funded Health Center
340B ID
CHC26632-01
Entity Address
1201 Sycamore Dr SE
Washington, DC 20032-5956
Grant Number
H80CS26632
Participating Start Date
4/1/2014
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
MAXOR SPECIALTY PHARMACY
Pharmacy Address
6101 43RD ST, STE C
LUBBOCK, TX 79407
Pharmacy Comments
Contract Details
Approval Date
7/12/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Naseema Shafi, Chief Executive Officer
(202) 797-3572
Contract Pharmacy Representative
Maxor
Jessie Heaton, Pharmacist-in-charge
(800) 658-6046
Signed By Date
7/12/2024
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