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WAL-MART PHARMACY 10-5047
CH021280 CAMCARE HEALTH CORPORATION
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Covered Entity Details
Entity Name
CAMCARE HEALTH CORPORATION
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH021280
Entity Address
817 FEDERAL STREET
CAMDEN, NJ 08103
Grant Number
H80CS00172
Participating Start Date
1/1/2002
Last Recertification Date
3/7/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5047
Pharmacy Address
130 BLACKHORSE PIKE
AUDUBON, NJ 08106
Pharmacy Comments
Contract Details
Approval Date
4/14/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARK K. BRYANT, CEO
(856) 541-3270
Contract Pharmacy Representative
Marcus Osborne, Vice President
(479) 204-9374
Signed By Date
4/14/2015
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