340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0839
RWI708062A Capitol City Family Health Center
Print
Covered Entity Details
Entity Name
Capitol City Family Health Center
Subdivision Name
Type
Ryan White Part A
340B ID
RWI708062A
Entity Address
3140 Florida Blvd
Baton Rouge, LA 70806
Grant Number
H89HA11432
Participating Start Date
7/1/2024
Last Recertification Date
3/9/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0839
Pharmacy Address
9350 CORTANA PL
BATON ROUGE, LA 70815
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Matthew Valliere, Chief Executive Officer
(225) 650-2026
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
1/12/2018
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