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WAL-MART PHARMACY 10-3475
RWI19403A Family Service of Montgomery County, Pennsylvania
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Covered Entity Details
Entity Name
Family Service of Montgomery County, Pennsylvania
Subdivision Name
Type
Ryan White Part A
340B ID
RWI19403A
Entity Address
1976 East High Street
Pottstown, PA 19464-3277
Grant Number
H89HA00013
Participating Start Date
7/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3475
Pharmacy Address
650 SOUTH TROOPER ROAD
NORRISTOWN, PA 19403
Pharmacy Comments
Contract Details
Approval Date
10/1/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kelly Canally, CEO
(610) 630-2111 Ext: 232
Contract Pharmacy Representative
Walmart
Nick Tallman, Sr. Director, Merchandise Operations – Pharmacy
(479) 371-0417
Signed By Date
10/1/2024
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