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WAL-MART PHARMACY 10-0759
CH044310 MCR Health, Inc.
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Covered Entity Details
Entity Name
MCR Health, Inc.
Subdivision Name
EDGAR J. PRICE FAMILY & CHILDREN HEALTHCARE CENTER
Type
HRSA-Funded Health Center
340B ID
CH044310
Entity Address
12271 US HIGHWAY 301 NORTH
Parrish, FL 34219-8410
Grant Number
H80CS00097
Participating Start Date
12/1/1992
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0759
Pharmacy Address
1480 HIGHWAY 17 NORTH
WAUCHULA, FL 33873
Pharmacy Comments
Contract Details
Approval Date
1/13/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/15/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Patrick Carnegie, President and CEO
(941) 776-4000 Ext: 224
Contract Pharmacy Representative
WAL-MART
MARCUS OSBORNE, VP OF HEALTH & WELLNESS SALES AND CONTRACTING
(479) 204-9374
Signed By Date
1/13/2020
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