Contract Pharmacy Details

WAL-MART PHARMACY 10-3235
CH044130 MIAMI BEACH COMMUNITY HEALTH CENTER INC.

Covered Entity Details

Entity Name

MIAMI BEACH COMMUNITY HEALTH CENTER INC.

Subdivision Name

MIAMI BEACH COMMUNITY HEALTH CENTER, INC.

Type

HRSA-Funded Health Center

340B ID

CH044130

Entity Address

710 Alton Rd
Miami Beach, FL 33139

Grant Number

H80CS00182

Participating Start Date

12/1/1992

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

WAL-MART PHARMACY 10-3235

Pharmacy Address

1425 NORTHEAST 163RD STREET
NORTH MIAMI BEACH, FL 33162

Pharmacy Comments

Contract Details

Approval Date

4/8/2015

Contract Begin Date

7/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/26/2016
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Mark Rabinowitz, CEO
(305) 538-8835 Ext: 1600

Contract Pharmacy Representative

Wal-Mart
Marcus Osbourne, Vice President
(800) 939-2022

Signed By Date

4/8/2015

340B Drug Pricing Program Database