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WAL-MART PHARMACY 10-0039
CH077570 COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
Subdivision Name
COMMUNITY HEALTH CENTER OF SOUTHEAST KS
Type
HRSA-Funded Health Center
340B ID
CH077570
Entity Address
3011 N Michigan St
Pittsburg, KS 66762-2546
Grant Number
H80CS00841
Participating Start Date
1/1/2005
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0039
Pharmacy Address
2500 SOUTH MAIN
FORT SCOTT, KS 66701
Pharmacy Comments
Contract Details
Approval Date
1/15/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KRISTA POSTAI, CEO
(620) 235-1867
Contract Pharmacy Representative
Wal-Mart Fort Scott
Michele Dunkeson, Chief Pharmacist
(620) 223-5051
Signed By Date
1/15/2018
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