Contract Pharmacy Details

WAL-MART PHARMACY 10-1426
CH051660 IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION

Covered Entity Details

Entity Name

IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION

Subdivision Name

IRONTON FAMILY MEDICAL CENTER

Type

HRSA-Funded Health Center

340B ID

CH051660

Entity Address

304 N 2ND ST
IRONTON, OH 45638-1491

Grant Number

H80CS00471

Participating Start Date

10/1/1996

Last Recertification Date

1/31/2017

Entity Termination Date

4/1/2017

Pharmacy Details

Pharmacy Name

WAL-MART PHARMACY 10-1426

Pharmacy Address

351 RIVER HILL ROAD
ASHLAND, KY 41101

Pharmacy Comments

Contract Details

Approval Date

8/17/2012

Contract Begin Date

8/17/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2017

Contacts

Covered Entity Signing Official

Nancy Lewis, Dir. of Health Services
(740) 532-3534

Contract Pharmacy Representative

Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374

Signed By Date

7/17/2012

340B Drug Pricing Program Database