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WAL-MART PHARMACY 10-0990
CH0452890 ESCAMBIA COMMUNITY CLINICS INC
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Covered Entity Details
Entity Name
ESCAMBIA COMMUNITY CLINICS INC
Subdivision Name
Escambia Community Clinics, Inc. Corporate Offices
Type
HRSA-Funded Health Center
340B ID
CH0452890
Entity Address
2315 West Jackson Street
PENSACOLA, FL 32505-1736
Grant Number
H80CS08755
Participating Start Date
1/1/2009
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0990
Pharmacy Address
4965 HIGHWAY 90
PACE (MILTON), FL 32571
Pharmacy Comments
Contract Details
Approval Date
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Chandra Smiley, Chief Executive Officer
(850) 472-0053
Contract Pharmacy Representative
Escambia Community Clinics, Inc.
Chandra Smiley, Chief Executive Officer
(850) 472-0053
Signed By Date
10/12/2023
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