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WAL-MART PHARMACY 10-5829
CH031525A PIEDMONT ACCESS TO HEALTH SERVICES INC
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Covered Entity Details
Entity Name
PIEDMONT ACCESS TO HEALTH SERVICES INC
Subdivision Name
PATHS Community Medical Center - DANVILLE
Type
HRSA-Funded Health Center
340B ID
CH031525A
Entity Address
705 Main St
Danville, VA 24541-1803
Grant Number
H80CS03972
Participating Start Date
10/1/2004
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5829
Pharmacy Address
211 NOR DAN DRIVE
UNIT #1010
DANVILLE, VA 24540
Pharmacy Comments
Contract Details
Approval Date
4/13/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert A Pratt, Chief Operating Officer
(434) 791-3630 Ext: 1005
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
4/13/2018
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