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WAL-MART PHARMACY 10-5997
CH033930 CHESPENN HEALTH SERVICES
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Covered Entity Details
Entity Name
CHESPENN HEALTH SERVICES
Subdivision Name
CHESPENN HEALTH SERVICES
Type
HRSA-Funded Health Center
340B ID
CH033930
Entity Address
1510 Chester Pike, Suite 200
Eddystone, PA 19022
Grant Number
H80CS00738
Participating Start Date
1/1/2003
Last Recertification Date
2/20/2025
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
4/15/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael G. Lucas, CEO and President
(610) 485-3800 Ext: 630
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/15/2019
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