Contract Pharmacy Details

WAL-MART PHARMACY 10-5440
CH101310 CLACKAMAS, COUNTY OF

Covered Entity Details

Entity Name

CLACKAMAS, COUNTY OF

Subdivision Name

Clackamas Health Centers Administration

Type

HRSA-Funded Health Center

340B ID

CH101310

Entity Address

2051 Kaen Road STE 367
Oregon City, OR 97045-4035

Grant Number

H80CS00547

Participating Start Date

4/1/2004

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

WAL-MART PHARMACY 10-5440

Pharmacy Address

10000 SOUTHEAST 82ND AVENUE
HAPPY VALLEY, OR 97086

Pharmacy Comments

Contract Details

Approval Date

4/16/2018

Contract Begin Date

7/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Deborah Cockrell, FQHC Director
(503) 742-5495

Contract Pharmacy Representative

WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498

Signed By Date

4/16/2018

340B Drug Pricing Program Database