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WAL-MART PHARMACY 10-5997
CH0112230 COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION
Subdivision Name
CHC'S OF RUTLAND REGION, INC.
Type
HRSA-Funded Health Center
340B ID
CH0112230
Entity Address
275 Route 30 N
Bomoseen, VT 05732-9647
Grant Number
H80CS06659
Participating Start Date
7/1/2006
Last Recertification Date
2/27/2025
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
7/24/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
GRANT WHITMER, EXECUTIVE DIRECTOR
(802) 855-2081
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/24/2017
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