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WALMART PHARMACY 10-5169
Acadiana Practitioners' Gastro Clinic
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Covered Entity Details
Entity Name
Acadiana Practitioners' Gastro Clinic
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
Entity Address
331 South Main Street
Opelousas, LA 70570
Grant Number
NH25PS005176
Participating Start Date
Last Recertification Date
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
Pharmacy Comments
Contract Details
Approval Date
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rhonda Bergeron, CEO
(337) 447-4027
Contract Pharmacy Representative
Walmart
Nick Tallman, Sr. Director, Merchandise Operations – Pharmacy
(479) 371-0417
Signed By Date
4/9/2025
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