Contract Pharmacy Details

WAL-MART PHARMACY 10-5997
CH047000 HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.

Covered Entity Details

Entity Name

HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.

Subdivision Name

Health Care Partners of South Carolina, Inc. - Conway Administrative Office

Type

HRSA-Funded Health Center

340B ID

CH047000

Entity Address

1708 Oak Street
Conway, SC 29526-3086

Grant Number

H80CS00411

Participating Start Date

12/1/1992

Last Recertification Date

2/18/2025

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

7/19/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/1/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Jim Eubanks, Chief Executive Officer
(843) 488-6363

Contract Pharmacy Representative

Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498

Signed By Date

7/19/2019

340B Drug Pricing Program Database