340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-4474
CH10717A PENINSULA COMMUNITY HEALTH SERVICES OF ALASKA, INC.
Print
Covered Entity Details
Entity Name
PENINSULA COMMUNITY HEALTH SERVICES OF ALASKA, INC.
Subdivision Name
Peninsula Community Health Services of Alaska
Type
HRSA-Funded Health Center
340B ID
CH10717A
Entity Address
230 East Marydale Ave
SOLDOTNA, AK 99669-7524
Grant Number
H80CS01139
Participating Start Date
10/1/2015
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-4474
Pharmacy Address
10096 KENAI SPUR HWY
KENAI, AK 99611
Pharmacy Comments
Contract Details
Approval Date
10/5/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Al Wall, CEO
(907) 260-7314
Contract Pharmacy Representative
Wal-Mart
Marcus Osbourne, VP of Health and Wellness Transformation
(479) 204-9374
Signed By Date
10/5/2016
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