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WAL-MART PHARMACY 10-2318
CH03406W PRIMARY HEALTH NETWORK, INC.
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Covered Entity Details
Entity Name
PRIMARY HEALTH NETWORK, INC.
Subdivision Name
Jacksonville Family Medicine Center
Type
HRSA-Funded Health Center
340B ID
CH03406W
Entity Address
29 Saltsburg Rd
Clarksburg, PA 15725-7400
Grant Number
H80CS00663
Participating Start Date
10/1/2006
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2318
Pharmacy Address
3100 OAKLAND AVE
INDIANA, PA 15701
Pharmacy Comments
Contract Details
Approval Date
10/7/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jennie Slabe, Chief Information Officer
(724) 342-3002 Ext: 1505
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/7/2024
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