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WAL-MART PHARMACY 10-3235
CH044130 MIAMI BEACH COMMUNITY HEALTH CENTER INC.
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Covered Entity Details
Entity Name
MIAMI BEACH COMMUNITY HEALTH CENTER INC.
Subdivision Name
MIAMI BEACH COMMUNITY HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH044130
Entity Address
710 Alton Rd
Miami Beach, FL 33139
Grant Number
H80CS00182
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3235
Pharmacy Address
1425 NORTHEAST 163RD STREET
NORTH MIAMI BEACH, FL 33162
Pharmacy Comments
Contract Details
Approval Date
1/16/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/30/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mark Rabinowitz, CEO
(305) 538-8835 Ext: 1600
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/16/2019
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