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WAL-MART PHARMACY 10-5315
CHC28351-00 FAMILY HEALTH SERVICES OF ERIE COUNTY
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Covered Entity Details
Entity Name
FAMILY HEALTH SERVICES OF ERIE COUNTY
Subdivision Name
Family Health Services of Erie County, Inc.
Type
HRSA-Funded Health Center
340B ID
CHC28351-00
Entity Address
1912 Hayes Ave
Sandusky, OH 44870
Grant Number
H80CS28351
Participating Start Date
10/1/2015
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5315
Pharmacy Address
2354 COMMERCE PARK DR.
ORLANDO, FL 32819
Pharmacy Comments
Contract Details
Approval Date
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Tatro, CEO
(419) 502-2822
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/15/2020
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