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WAL-MART PHARMACY 10-1264
CHC26575-04 COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY
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Covered Entity Details
Entity Name
COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY
Subdivision Name
Benjamin Logan School-Based Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26575-04
Entity Address
4560 County Road 26 Ste 2
Bellefontaine, OH 43311-9532
Grant Number
H80CS26575
Participating Start Date
4/1/2022
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1264
Pharmacy Address
2281 US HIGHWAY 68 S
BELLEFONTAINE, OH 43311-8904
Pharmacy Comments
Contract Details
Approval Date
10/14/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tara Bair, President/CEO
(937) 599-1411 Ext: 250
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/14/2024
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