340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
CH0413490 EAST TENNESSEE STATE UNIVERSITY
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Covered Entity Details
Entity Name
EAST TENNESSEE STATE UNIVERSITY
Subdivision Name
EAST TENNESSEE STATE UNIVERSITY COLLEGE OF NURSING
Type
HRSA-Funded Health Center
340B ID
CH0413490
Entity Address
400 JL Seehorn Road
JOHNSON CITY, TN 37614
Grant Number
H80CS00840
Participating Start Date
7/1/1995
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
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
Melissa Queen, Business Director
(423) 439-4076
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
7/12/2024
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