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WAL-MART PHARMACY 10-2109
CH021270 COMMUNITY HEALTH CARE, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CARE, INC.
Subdivision Name
CompleteCare Adult & Specialty Medical Professionals
Type
HRSA-Funded Health Center
340B ID
CH021270
Entity Address
30 N Pearl St
BRIDGETON, NJ 08302
Grant Number
H80CS00164
Participating Start Date
1/1/2001
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2109
Pharmacy Address
2291 N. SECOND ST.
MILLVILLE, NJ 08332
Pharmacy Comments
Contract Details
Approval Date
11/21/2012
Contract Begin Date
10/26/2012
Carve-In Effective Date
Contract Comments
11/21/2012 - public health emergency declared in the state of NJ effective 10/26/2012
Contacts
Covered Entity Signing Official
Gilbert Walter, CEO
(856) 391-1127
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
10/10/2012
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