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WAL-MART PHARMACY 10-5997
CH030890 PRESTON TAYLOR COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
PRESTON TAYLOR COMMUNITY HEALTH CENTER
Subdivision Name
Preston-Taylor Community Health
Type
HRSA-Funded Health Center
340B ID
CH030890
Entity Address
725 N Pike St
Grafton, WV 26354-1270
Grant Number
H80CS00617
Participating Start Date
7/1/2004
Last Recertification Date
2/26/2025
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
4/15/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Linda M. Shriver, CEO
(304) 265-0312
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/15/2020
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