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WAL-MART PHARMACY 10-5997
CH100160 COMMUNITY HEALTH CLINICS, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CLINICS, INC.
Subdivision Name
TERRY REILLY HEALTH SERVICES
Type
HRSA-Funded Health Center
340B ID
CH100160
Entity Address
211 16th Ave N
Nampa, ID 83687-4058
Grant Number
H80CS00636
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
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
7/18/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Heidi Hart, CEO
(208) 318-1255
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
7/18/2017
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