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WAL-MART PHARMACY 10-5997
CH041110 FETTER HEALTHCARE NETWORK INC.
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Covered Entity Details
Entity Name
FETTER HEALTHCARE NETWORK INC.
Subdivision Name
FRANKLIN C FETTER FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH041110
Entity Address
51 Nassau St
Charleston, SC 29403-5513
Grant Number
H80CS09088
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
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
7/18/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Aretha Jones, CEO
(843) 722-4112 Ext: 3004
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/18/2018
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