Contract Pharmacy Details

WAL-MART CENTRAL FILL 10-2670
CH049070 COMMUNITY HEALTH CENTERS OF PINELLAS, INC.

Covered Entity Details

Entity Name

COMMUNITY HEALTH CENTERS OF PINELLAS, INC.

Subdivision Name

Evara Health - Johnnie Ruth Clarke

Type

HRSA-Funded Health Center

340B ID

CH049070

Entity Address

1344 22nd St S
Saint Petersburg, FL 33712-2744

Grant Number

H80CS00463

Participating Start Date

12/1/1992

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WAL-MART CENTRAL FILL 10-2670

Pharmacy Address

608 SPRING HILL DR # 3 SUITE 300
SPRING, TX 77386

Pharmacy Comments

Contract Details

Approval Date

7/20/2017

Contract Begin Date

10/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/2/2018
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Pat Mabe, CEO
(727) 824-8100

Contract Pharmacy Representative

Walmart
Julie Howard, 340B Program Manager
(479) 277-1498

Signed By Date

7/20/2017

340B Drug Pricing Program Database