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WAL-MART PHARMACY 10-5997
CH0442510 CHOTA COMMUNITY HEALTH SERVICES
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Covered Entity Details
Entity Name
CHOTA COMMUNITY HEALTH SERVICES
Subdivision Name
CHOTA COMMUNITY HEALTH SERVICES
Type
HRSA-Funded Health Center
340B ID
CH0442510
Entity Address
1206 US Highway 411
VONORE, TN 37885
Grant Number
H80CS06461
Participating Start Date
10/20/2005
Last Recertification Date
2/20/2025
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
7/13/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Laura Harris, CEO
(423) 442-7268
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/13/2017
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