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WAL-MART PHARMACY 10-5997
CH0510700 OPEN DOOR HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
OPEN DOOR HEALTH SERVICES, INC.
Subdivision Name
Open Door Health Services
Type
HRSA-Funded Health Center
340B ID
CH0510700
Entity Address
333 S Madison Street
Suite 79
Muncie, IN 47305
Grant Number
H80CS00340
Participating Start Date
4/1/2001
Last Recertification Date
2/12/2025
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
1/20/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bryan Ayars, CEO
(765) 747-2971
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/20/2017
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