340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0986
FQHCLA324 SUMMIT COMMUNITY CARE CLINIC
Print
Covered Entity Details
Entity Name
SUMMIT COMMUNITY CARE CLINIC
Subdivision Name
Summit Community Care Clinic, Inc.
Type
Health Center Program Look-Alike
340B ID
FQHCLA324
Entity Address
360 Peak One Drive STE 100
Frisco, CO 80443
Grant Number
LALCS00138
Participating Start Date
10/1/2014
Last Recertification Date
2/19/2015
Entity Termination Date
10/1/2015
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0986
Pharmacy Address
840 SUMMIT BLVD.
P.O. BOX 4220
FRISCO, CO 80443
Pharmacy Comments
Contract Details
Approval Date
1/15/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2015
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Sarah E. Vaine, CEO
(970) 668-4049
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
1/15/2015
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session