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WAL-MART PHARMACY 10-5997
CHC12890-00 FAIRFIELD COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
FAIRFIELD COMMUNITY HEALTH CENTER
Subdivision Name
FCHC South
Type
HRSA-Funded Health Center
340B ID
CHC12890-00
Entity Address
220 E Walnut St
Lancaster, OH 43130-4464
Grant Number
H80CS19595
Participating Start Date
7/1/2010
Last Recertification Date
2/10/2025
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
10/11/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lauree Althaus, Director of Finance
(740) 277-6043 Ext: 1001
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
10/11/2018
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