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Walmart Pharmacy 10-7611
CHC26561-00 HCC Network
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Covered Entity Details
Entity Name
HCC Network
Subdivision Name
HCC Network - Waverly
Type
HRSA-Funded Health Center
340B ID
CHC26561-00
Entity Address
608 Missouri St
Waverly, MO 64096-8241
Grant Number
H80CS26561
Participating Start Date
7/1/2014
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
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
Toniann Richard, Executive Director
(660) 259-2440
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/14/2024
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