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WAL-MART PHARMACY 10-2890
CH045211E FIRST CHOICE PRIMARY CARE, INC.
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Covered Entity Details
Entity Name
FIRST CHOICE PRIMARY CARE, INC.
Subdivision Name
Daybreak Center Suite A
Type
HRSA-Funded Health Center
340B ID
CH045211E
Entity Address
174 Walnut Street
Macon, GA 31201-3440
Grant Number
H80CS08242
Participating Start Date
10/1/2016
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2890
Pharmacy Address
5955 ZEBULON RD
MACON, GA 31210
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Katherine McLeod, CEO
(478) 254-7204
Contract Pharmacy Representative
Walmart
Julie Howard, 340b Program Manager
(479) 739-1973 Ext: 4792771498
Signed By Date
7/15/2024
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