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WAL-MART PHARMACY 10-3633
CH032700 KEYSTONE RURAL HEALTH CENTER
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Covered Entity Details
Entity Name
KEYSTONE RURAL HEALTH CENTER
Subdivision Name
ADMINISTRATION
Type
HRSA-Funded Health Center
340B ID
CH032700
Entity Address
111 Chambers Hill Drive, Suite 200
CHAMBERSBURG, PA 17201
Grant Number
H80CS00076
Participating Start Date
1/1/2000
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3633
Pharmacy Address
12751 WASHINGTON TOWNSHIP BLVD
WAYNESBORO, PA 17268
Pharmacy Comments
Contract Details
Approval Date
1/14/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JOANNE COCHRAN, PRESIDENT AND CEO
(717) 709-7906
Contract Pharmacy Representative
Walmart
Christian Nava, Senior Manager, Program Development-340B
(210) 632-0647
Signed By Date
1/14/2025
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