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WAL-MART PHARMACY 10-5997
CH020620 Cornerstone Family Healthcare
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Covered Entity Details
Entity Name
Cornerstone Family Healthcare
Subdivision Name
Cornerstone Family Healthcare: The Kaplan Family Pavilion
Type
HRSA-Funded Health Center
340B ID
CH020620
Entity Address
147 Lake St
Newburgh, NY 12550
Grant Number
H80CS00469
Participating Start Date
1/1/1999
Last Recertification Date
2/13/2025
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
1/14/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
LINDA S. MULLER, CEO
(845) 220-3130
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/14/2020
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