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WAL-MART PHARMACY 10-5997
CH0216220 OCEAN HEALTH INITIATIVES
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Covered Entity Details
Entity Name
OCEAN HEALTH INITIATIVES
Subdivision Name
OCEAN HEALTH INITIATIVES LAKEWOOD SITE
Type
HRSA-Funded Health Center
340B ID
CH0216220
Entity Address
101 2nd St
Lakewood, NJ 08701-3324
Grant Number
H80CS06656
Participating Start Date
10/1/2004
Last Recertification Date
2/10/2025
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
1/21/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
THERESA BERGER, CEO
(732) 363-6655
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/21/2020
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