340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0884
CHC26566-30 Jane Pauley Community Health Center, Inc.
Print
Covered Entity Details
Entity Name
Jane Pauley Community Health Center, Inc.
Subdivision Name
Jane Pauley Community Health Center at LaFountain Street Kokomo
Type
HRSA-Funded Health Center
340B ID
CHC26566-30
Entity Address
3510 S Lafountain St
Kokomo, IN 46902-3803
Grant Number
H80CS26566
Participating Start Date
1/1/2025
Last Recertification Date
2/10/2025
Entity Termination Date
7/1/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0884
Pharmacy Address
2500 PROGRESS PKWY
SHELBYVILLE, IN 46176
Pharmacy Comments
Contract Details
Approval Date
10/1/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Aaron Knapp, Dir of Pharmacy Operations
(812) 632-0917
Contract Pharmacy Representative
Walmart
Van Donn, 340B Director Contracting
(479) 273-4000
Signed By Date
10/1/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session