Contract Pharmacy Details

WAL-MART PHARMACY 10-5945
CH044130 MIAMI BEACH COMMUNITY HEALTH CENTER INC.

Covered Entity Details

Entity Name

MIAMI BEACH COMMUNITY HEALTH CENTER INC.

Subdivision Name

MIAMI BEACH COMMUNITY HEALTH CENTER, INC.

Type

HRSA-Funded Health Center

340B ID

CH044130

Entity Address

710 Alton Rd
Miami Beach, FL 33139

Grant Number

H80CS00182

Participating Start Date

12/1/1992

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

WAL-MART PHARMACY 10-5945

Pharmacy Address

400 W. 49TH
HIALEAH, FL 33012

Pharmacy Comments

Contract Details

Approval Date

4/14/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/30/2022
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Mark Rabinowitz, CEO
(305) 538-8835 Ext: 1600

Contract Pharmacy Representative

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

Signed By Date

4/14/2020

340B Drug Pricing Program Database