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WAL-MART PHARMACY 10-2628
CH04814F HEALTHFIRST BLUEGRASS, INC.
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Covered Entity Details
Entity Name
HEALTHFIRST BLUEGRASS, INC.
Subdivision Name
HealthFirst Bluegrass Mobile 1 Dental Clinic
Type
HRSA-Funded Health Center
340B ID
CH04814F
Entity Address
496 Southland Drive
Lexington, KY 40503-1827
Grant Number
H80CS28202
Participating Start Date
1/1/2017
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2628
Pharmacy Address
4051 NICHOLASVILLE ROAD
LEXINGTON (SW), KY 40503
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
Wayne Linscott, CEO
(859) 270-0192
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
7/15/2024
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