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WAL-MART PHARMACY 10-5997
CH06024D FIRST CHOICE COMMUNITY HEALTHCARE
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Covered Entity Details
Entity Name
FIRST CHOICE COMMUNITY HEALTHCARE
Subdivision Name
NORTH VALLEY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH06024D
Entity Address
1231 Candelaria Rd NW
Albuquerque, NM 87107-2767
Grant Number
H80CS00202
Participating Start Date
12/1/1992
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5997
Pharmacy Address
9600 PARKSOUTH CT. SUITE 100
ORLANDO, FL 32837
Pharmacy Comments
Contract Details
Approval Date
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ROBERT DEFELICE, CEO
(505) 873-7401
Contract Pharmacy Representative
CH060240
ROBERT DEFELICE, CEO
(505) 873-7401
Signed By Date
7/17/2018
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