340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-1175
CH092890 NORTH COUNTRY HEALTHCARE, INC.
Print
Covered Entity Details
Entity Name
NORTH COUNTRY HEALTHCARE, INC.
Subdivision Name
NORTH COUNTRY - FLAGSTAFF CLINIC
Type
HRSA-Funded Health Center
340B ID
CH092890
Entity Address
2920 N 4th St
Flagstaff, AZ 86004-1816
Grant Number
H80CS00651
Participating Start Date
7/1/1998
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1175
Pharmacy Address
2750 WOODLANDS VILLAGE BLVD.
FLAGSTAFF, AZ 86001
Pharmacy Comments
Contract Details
Approval Date
7/10/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ANNE NEWLAND, CEO
(928) 522-9564
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/10/2017
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