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WAL-MART PHARMACY 10-5997
CHC28352-02 ISABELLA CITIZENS FOR HEALTH, INC.
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Covered Entity Details
Entity Name
ISABELLA CITIZENS FOR HEALTH, INC.
Subdivision Name
Isabella Citizens for Health
Type
HRSA-Funded Health Center
340B ID
CHC28352-02
Entity Address
2790 Health Pkwy
Mount Pleasant, MI 48858
Grant Number
H80CS28352
Participating Start Date
1/1/2020
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
2/26/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jennifer White, Chief Executive Officer
(989) 953-5191 Ext: 1
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
2/26/2020
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