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WAL-MART PHARMACY 10-1358
CH041180 FAMILY HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH CENTERS, INC.
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH041180
Entity Address
3310 MAGNOLIA ST
ORANGEBURG, SC 29115
Grant Number
H80CS00090
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1358
Pharmacy Address
2110 BELLS HIGHWAY
WALTERBORO, SC 29488
Pharmacy Comments
Contract Details
Approval Date
4/2/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/14/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Leon A. Brunson Sr., CEO
(803) 531-6905
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
4/2/2013
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