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WAL-MART PHARMACY 10-1502
CH04668B1 RURAL HEALTH GROUP, INC.
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Covered Entity Details
Entity Name
RURAL HEALTH GROUP, INC.
Subdivision Name
Rural Health Group Pediatrics and Dental
Type
HRSA-Funded Health Center
340B ID
CH04668B1
Entity Address
2064 NC HIGHWAY 125
ROANOKE RAPIDS, NC 27870-9436
Grant Number
H80CS00866
Participating Start Date
1/1/2008
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1502
Pharmacy Address
251 PREMIER BLVD
ROANOKE RAPIDS, NC 27870
Pharmacy Comments
Contract Details
Approval Date
1/15/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
BRIAN O. HARRIS, CEO
(252) 536-5929
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
1/15/2014
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