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WAL-MART PHARMACY 10-0577
CHC24108-05 HEALTH PARTNERSHIP CLINIC, INC.
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Covered Entity Details
Entity Name
HEALTH PARTNERSHIP CLINIC, INC.
Subdivision Name
Health Partnership Clinic, Inc.
Type
HRSA-Funded Health Center
340B ID
CHC24108-05
Entity Address
107 South Main Street
Ottawa, KS 66067
Grant Number
H80CS24108
Participating Start Date
10/1/2017
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0577
Pharmacy Address
13600 SO. ALDEN STREET
OLATHE, KS 66062
Pharmacy Comments
Contract Details
Approval Date
7/17/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Amy Falk, CEO
(913) 648-2266
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
7/17/2017
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