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WAL-MART PHARMACY 10-0714
CH060060 Lee County Cooperative Clinic dba Olly Neal Community Health Center
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Covered Entity Details
Entity Name
Lee County Cooperative Clinic dba Olly Neal Community Health Center
Subdivision Name
Lee County Cooperative Clinic dba Olly Neal Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH060060
Entity Address
558 Atkins Blvd
Marianna, AR 72360-2113
Grant Number
H80CS00122
Participating Start Date
12/1/1992
Last Recertification Date
3/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0714
Pharmacy Address
STORE 10-0714
602 SHEILA STREET
WEST HELENA, AR 72390
Pharmacy Comments
Contract Details
Approval Date
4/21/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
April Peer, CEO
(870) 295-5225 Ext: 4266
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/21/2017
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