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WAL-MART PHARMACY 10-3560
CH010700 BROCKTON NEIGHBORHOOD HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
BROCKTON NEIGHBORHOOD HEALTH CENTER, INC.
Subdivision Name
BROCKTON NEIGHBORHOOD HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH010700
Entity Address
63 Main St
Brockton, MA 02301
Grant Number
H80CS00560
Participating Start Date
4/1/1999
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3560
Pharmacy Address
638 QUEQUECHAN STREET
FALL RIVER, MA 02721
Pharmacy Comments
Contract Details
Approval Date
4/16/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
SUSAN G. JOSS, Senior Advisor
(508) 894-3203
Contract Pharmacy Representative
Walmart
Nick Tallman, Sr. Director, Merchandise Operations – Pharmacy
(479) 371-0417
Signed By Date
4/16/2025
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