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WAL-MART PHARMACY 10-2703
HV00789 HOPEHEALTH, INC.
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Covered Entity Details
Entity Name
HOPEHEALTH, INC.
Subdivision Name
Type
Ryan White Part C
340B ID
HV00789
Entity Address
360 N. Irby Street
FLORENCE, SC 29501
Grant Number
H76HA00789
Participating Start Date
7/1/2003
Last Recertification Date
2/20/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2703
Pharmacy Address
2014 SO. IRBY STREET
FLORENCE, SC 29505
Pharmacy Comments
Contract Details
Approval Date
7/10/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/10/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Carl Humphries, CEO
(843) 667-9414 Ext: 1500
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
7/10/2014
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