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WAL-MART PHARMACY 10-1318
FQHCLA184B CHEROKEE HEALTH SYSTEMS
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Covered Entity Details
Entity Name
CHEROKEE HEALTH SYSTEMS
Subdivision Name
CHS Sevier County
Type
Health Center Program Look-Alike
340B ID
FQHCLA184B
Entity Address
10731 Chapman Hwy
Seymour, TN 37865-4765
Grant Number
LALCS00020
Participating Start Date
7/1/2013
Last Recertification Date
2/19/2015
Entity Termination Date
1/1/2016
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1318
Pharmacy Address
6777 CLINTON HWY
KNOXVILLE (NW), TN 37912
Pharmacy Comments
Contract Details
Approval Date
4/14/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2016
Contacts
Covered Entity Signing Official
Joel Hornberger, CSO
(865) 544-0406
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
4/14/2014
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