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WAL-MART PHARMACY 10-3703
CHC24198-00 Marillac Community Health Centers
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Covered Entity Details
Entity Name
Marillac Community Health Centers
Subdivision Name
DCHC-Carrollton
Type
HRSA-Funded Health Center
340B ID
CHC24198-00
Entity Address
3201 S. Carrollton Ave.
New Orleans, LA 70118-4307
Grant Number
H80CS24198
Participating Start Date
10/1/2012
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3703
Pharmacy Address
3520 WILLIAMS BLVD
KENNER, LA 70065
Pharmacy Comments
Contract Details
Approval Date
1/10/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/18/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michael Griffin, President & CEO
(504) 212-9501
Contract Pharmacy Representative
Wal-Mart
Marcus Osbourne, VP of Health and Wellness Transformation
(479) 204-9374
Signed By Date
1/10/2017
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