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WAL-MART PHARMACY 10-1528
CH071857F Eastern Iowa Health Center
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Covered Entity Details
Entity Name
Eastern Iowa Health Center
Subdivision Name
Eastern Iowa Health Center - Pharmacy & Urgent Care
Type
HRSA-Funded Health Center
340B ID
CH071857F
Entity Address
400 12th St SE
Cedar Rapids, IA 52403-4051
Grant Number
H80CS08226
Participating Start Date
7/1/2021
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1528
Pharmacy Address
2645 BLAIRS FERRY RD
CEDAR RAPIDS, IA 52402
Pharmacy Comments
Contract Details
Approval Date
4/13/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James Lock, President & CEO
(319) 730-7300
Contract Pharmacy Representative
Walmart
Nick Tallman, Sr. Director, Merchandise Operations – Pharmacy
(479) 371-0417
Signed By Date
4/13/2025
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