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WAL-MART PHARMACY 10-1064
CHC12870-00 WEST CALDWELL HEALTH COUNCIL INC
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Covered Entity Details
Entity Name
WEST CALDWELL HEALTH COUNCIL INC
Subdivision Name
Collettsville Medical Center
Type
HRSA-Funded Health Center
340B ID
CHC12870-00
Entity Address
4330 Collettsville Rd
Collettsville, NC 28611-9000
Grant Number
H80CS12870
Participating Start Date
10/30/2024
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1064
Pharmacy Address
935 BLOWING ROCK BLVD
LENOIR, NC 28645
Pharmacy Comments
Contract Details
Approval Date
10/30/2024
Contract Begin Date
10/30/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas B McRary, CEO
(828) 754-2409 Ext: 160
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/15/2024
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