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WAL-MART PHARMACY 10-0164
CH04686A ACCESS FAMILY HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
ACCESS FAMILY HEALTH SERVICES, INC.
Subdivision Name
ACCESS FAMILY HEALTH SERVICES - TUPELO
Type
HRSA-Funded Health Center
340B ID
CH04686A
Entity Address
499 Gloster Creek Vlg
Tupelo, MS 38801-4600
Grant Number
H80CS00633
Participating Start Date
7/1/2008
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0164
Pharmacy Address
100 MCCORD ROAD
PONTOTOC, MS 38863
Pharmacy Comments
Contract Details
Approval Date
4/15/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARILYN SUMERFORD, CEO
(662) 651-4686 Ext: 8103
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/15/2025
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