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WAL-MART PHARMACY 10-1813
CH028210 FINGER LAKES MIGRANT HEALTH CARE PROJECT, INC.
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Covered Entity Details
Entity Name
FINGER LAKES MIGRANT HEALTH CARE PROJECT, INC.
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH028210
Entity Address
14 Maiden Lane
PENN YAN, NY 14527
Grant Number
H80CS00849
Participating Start Date
7/1/2003
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1813
Pharmacy Address
6788 ROUTE 31 EAST
VILLAGE OF NEWARK, NY 14513
Pharmacy Comments
Contract Details
Approval Date
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mary A Zelazny, CEO
(315) 531-9102
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/15/2019
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