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WAL-MART PHARMACY 10-5997
CH0537630 MUSKINGUM VALLEY HEALTH CENTERS
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Covered Entity Details
Entity Name
MUSKINGUM VALLEY HEALTH CENTERS
Subdivision Name
Muskingum Valley Health Centers
Type
HRSA-Funded Health Center
340B ID
CH0537630
Entity Address
859 N Main St
Malta, OH 43758-9007
Grant Number
H80CS08783
Participating Start Date
4/1/2008
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
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/19/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
DAN J ATKINSON, CEO
(740) 891-9090
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/16/2023
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