340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-4477
CHC26514-00 TRIAD ADULT AND PEDIATRIC MEDICINE, INC.
Print
Covered Entity Details
Entity Name
TRIAD ADULT AND PEDIATRIC MEDICINE, INC.
Subdivision Name
TAPM Pediatrics at Wendover
Type
HRSA-Funded Health Center
340B ID
CHC26514-00
Entity Address
1046 E Wendover Ave
Greensboro, NC 27405-6712
Grant Number
H80CS26514
Participating Start Date
1/1/2015
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-4477
Pharmacy Address
2710 NORTH MAIN ST.
HIGH POINT, NC 27265
Pharmacy Comments
Contract Details
Approval Date
4/12/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/7/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michelle Lewis, CEO
(336) 355-9715
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
4/12/2017
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