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WALMART PHARMACY 10-7281
CH0627190 FRONTERA HEALTHCARE NETWORK
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Covered Entity Details
Entity Name
FRONTERA HEALTHCARE NETWORK
Subdivision Name
FRONTERA HEALTHCARE NETWORK
Type
HRSA-Funded Health Center
340B ID
CH0627190
Entity Address
604 EAKER STREET
Suite
EDEN, TX 76837
Grant Number
H80CS08225
Participating Start Date
1/1/2008
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-7281
Pharmacy Address
3440 S BRYANT BLVD
SAN ANGELO, TX 76903-7271
Pharmacy Comments
Contract Details
Approval Date
10/5/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cam Kleibrink, CEO
(325) 869-5500
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
10/5/2016
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