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Walmart Pharmacy 10-7611
CH060060 Lee County Cooperative Clinic dba Olly Neal Community Health Center
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Covered Entity Details
Entity Name
Lee County Cooperative Clinic dba Olly Neal Community Health Center
Subdivision Name
Lee County Cooperative Clinic dba Olly Neal Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH060060
Entity Address
558 Atkins Blvd
Marianna, AR 72360-2113
Grant Number
H80CS00122
Participating Start Date
12/1/1992
Last Recertification Date
3/10/2025
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
Kellee Farris, CEO
(870) 295-5225 Ext: 4623
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/14/2024
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