340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0771
CH043823B BREVARD HEALTH ALLIANCE INC., THE
Print
Covered Entity Details
Entity Name
BREVARD HEALTH ALLIANCE INC., THE
Subdivision Name
BHA PALM BAY CLINIC
Type
HRSA-Funded Health Center
340B ID
CH043823B
Entity Address
5270 Babcock St NE STE 1
Palm Bay, FL 32905-4616
Grant Number
H80CS04213
Participating Start Date
4/1/2005
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0771
Pharmacy Address
1500 E. MERRITT ISLAND
MERITT ISLAND, FL 32952
Pharmacy Comments
Contract Details
Approval Date
1/11/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/17/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Richard Austin Helton, CEO
(321) 241-6868
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
1/11/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session