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WAL-MART PHARMACY 10-5325
STD349502 Oceana Community Health Inc
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Covered Entity Details
Entity Name
Oceana Community Health Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD349502
Entity Address
2215 Nebraska Avenue
1E
Fort Pierce, FL 34950
Grant Number
NH25PS005131
Participating Start Date
7/1/2023
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5325
Pharmacy Address
5555 W ATLANTIC BLVD
MARGATE, FL 33063
Pharmacy Comments
Contract Details
Approval Date
7/17/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Youssef Motii, Executive Director
(561) 543-2236
Contract Pharmacy Representative
Walmart
Tisha Campbell, Director of Contracting
(949) 872-4138
Signed By Date
7/17/2023
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