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WAL-MART PHARMACY 10-5997
CH0310560 JOHNSON HEALTH CENTER
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Covered Entity Details
Entity Name
JOHNSON HEALTH CENTER
Subdivision Name
JOHNSON HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH0310560
Entity Address
320 Federal St
Lynchburg, VA 24504-2306
Grant Number
H80CS02445
Participating Start Date
10/1/2004
Last Recertification Date
2/10/2025
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
7/14/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gary Campbell, CEO
(434) 455-2480 Ext: 1102
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
7/14/2017
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