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WAL-MART PHARMACY 10-5997
CH010380 REGIONAL MEDICAL CENTER AT LUBEC
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Covered Entity Details
Entity Name
REGIONAL MEDICAL CENTER AT LUBEC
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH010380
Entity Address
43 SOUTH LUBEC ROAD
LUBEC, ME 04652
Grant Number
H80CS00150
Participating Start Date
1/1/1997
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
7/12/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marilyn F. Hughes, CEO
(207) 733-1090 Ext: 5201
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/12/2021
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