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WALMART PHARMACY 10-5169
CH040380 NORTH FLORIDA MEDICAL CENTERS, INC.
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Covered Entity Details
Entity Name
NORTH FLORIDA MEDICAL CENTERS, INC.
Subdivision Name
North Florida Medical Centers, Inc.
Type
HRSA-Funded Health Center
340B ID
CH040380
Entity Address
2804 Remington Green Cir
Tallahassee, FL 32308-8707
Grant Number
H80CS00693
Participating Start Date
4/1/2001
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
Pharmacy Comments
Contract Details
Approval Date
4/6/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tori Wiggins, CFO
(850) 298-6040
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/6/2023
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