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WAL-MART PHARMACY 10-1986
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 10-1986
Pharmacy Address
340 WEST WIND DR
NORWALK, OH 44857
Pharmacy Comments
Contract Details
Approval Date
10/17/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/6/2023
Business decision by covered entity and/or pharmacy
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
10/17/2022
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