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WAL-MART PHARMACY 10-5315
CH010460 HEALTHREACH COMMUNITY HEALTH CENTERS
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Covered Entity Details
Entity Name
HEALTHREACH COMMUNITY HEALTH CENTERS
Subdivision Name
BINGHAM AREA HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH010460
Entity Address
237 Main St
Bingham, ME 04920
Grant Number
H80CS00797
Participating Start Date
10/1/2001
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5315
Pharmacy Address
2354 COMMERCE PARK DR.
ORLANDO, FL 32819
Pharmacy Comments
Contract Details
Approval Date
7/14/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/5/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
CONSTANCE COGGINS, CEO
(207) 872-5610
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/14/2020
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