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WAL-MART PHARMACY 10-5997
CH030900 SHENANDOAH VALLEY MEDICAL SYSTEM, INCORPORATED
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Covered Entity Details
Entity Name
SHENANDOAH VALLEY MEDICAL SYSTEM, INCORPORATED
Subdivision Name
SCH Martinsburg
Type
HRSA-Funded Health Center
340B ID
CH030900
Entity Address
99 TAVERN ROAD
MARTINSBURG, WV 25401
Grant Number
H80CS00781
Participating Start Date
10/1/2001
Last Recertification Date
2/28/2025
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
7/14/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Hassing, CEO
(304) 596-2610 Ext: 1062
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
7/14/2020
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