340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Walmart Pharmacy 10-7611
CH07440A DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.
Print
Covered Entity Details
Entity Name
DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.
Subdivision Name
DOUGLAS COUNTY PUBLIC HEALTH
Type
HRSA-Funded Health Center
340B ID
CH07440A
Entity Address
504 W. Broadway Ave.
AVA, MO 65608-1359
Grant Number
H80CS00457
Participating Start Date
4/1/2004
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
4/9/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Randall L Gann, CEO
(417) 683-5739
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
4/9/2025
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session