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Walmart Pharmacy 10-7611
CHC31240-00 FIRST PERSON CARE CLINIC
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Covered Entity Details
Entity Name
FIRST PERSON CARE CLINIC
Subdivision Name
First Person Care Clinic
Type
HRSA-Funded Health Center
340B ID
CHC31240-00
Entity Address
1200 S 4TH ST
111
LAS VEGAS, NV 89104-1046
Grant Number
H80CS31240
Participating Start Date
4/1/2018
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
1/9/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Diego Martinez, CEO
(305) 992-5149
Contract Pharmacy Representative
Walmart
Nick Tallman, Sr. Director, Merchandise Operations – Pharmacy
(479) 371-0417
Signed By Date
1/9/2025
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