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WAL-MART PHARMACY 10-5854
CH040310 BORINQUEN HEALTH CARE CENTER INC
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Covered Entity Details
Entity Name
BORINQUEN HEALTH CARE CENTER INC
Subdivision Name
BMC Emilio Lopez Pavilion (Main Site)
Type
HRSA-Funded Health Center
340B ID
CH040310
Entity Address
3601 Federal Hwy
Miami, FL 33137-3795
Grant Number
H80CS00618
Participating Start Date
4/1/1996
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5854
Pharmacy Address
8400 CORAL WAY
MIAMI, FL 33155
Pharmacy Comments
Contract Details
Approval Date
10/6/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Carl Velez, CEO
(305) 788-5055
Contract Pharmacy Representative
Walmart
Van Donn, Director of Contracting 340b
(303) 261-5549
Signed By Date
10/6/2023
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