340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALMART PHARMACY #10-5005
CH0420630 I.M. SULZBACHER CENTER FOR THE HOMELESS
Print
Covered Entity Details
Entity Name
I.M. SULZBACHER CENTER FOR THE HOMELESS
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH0420630
Entity Address
611 EAST ADAMS STREET
JACKSONVILLE, FL 32202
Grant Number
H80CS00305
Participating Start Date
7/1/2002
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WALMART PHARMACY #10-5005
Pharmacy Address
6855 WILSON BOULEVARD
JACKSONVILLE, FL 32210
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cindy Funkhouser, CEO
(904) 394-8069
Contract Pharmacy Representative
Walmart
Van Donn, Director of Contracting 340b
(303) 261-5549
Signed By Date
10/16/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session