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WAL-MART PHARMACY 10-5997
CH012080 COMMUNITY HEALTH CENTER, INCORPORATED
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER, INCORPORATED
Subdivision Name
CHC of Middletown
Type
HRSA-Funded Health Center
340B ID
CH012080
Entity Address
675 Main St
Middletown, CT 06457
Grant Number
H80CS00326
Participating Start Date
4/1/2002
Last Recertification Date
2/14/2025
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
Mark Masselli, President and CEO
(860) 347-6971
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
4/15/2019
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