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WAL-MART PHARMACY 10-0272
CHC24149-19 MERCY HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
MERCY HEALTH SERVICES, INC.
Subdivision Name
Mercy office at FSSD Johnson Elementary School
Type
HRSA-Funded Health Center
340B ID
CHC24149-19
Entity Address
815 Glass Ln
Franklin, TN 37064-2465
Grant Number
H80CS24149
Participating Start Date
1/1/2025
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0272
Pharmacy Address
3600 MALLORY LANE
FRANKLIN, TN 37067
Pharmacy Comments
Contract Details
Approval Date
11/12/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rhonda Sizemore, CFO
(615) 790-0567 Ext: 206
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
11/7/2024
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