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WAL-MART PHARMACY 10-5997
CH057880 WILL COUNTY COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
WILL COUNTY COMMUNITY HEALTH CENTER
Subdivision Name
WILL COUNTY COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH057880
Entity Address
1106 Neal Ave
Joliet, IL 60433-2548
Grant Number
H80CS00476
Participating Start Date
7/1/2001
Last Recertification Date
3/7/2025
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
10/13/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/5/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mary Maragos, Chief Executive Officer
(815) 740-7635
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/13/2021
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