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WAL-MART PHARMACY 10-5997
CH020070 HENRY J. AUSTIN HEALTH CENTER INC
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Covered Entity Details
Entity Name
HENRY J. AUSTIN HEALTH CENTER INC
Subdivision Name
Henry J. Austin Health Center - Warren
Type
HRSA-Funded Health Center
340B ID
CH020070
Entity Address
321 N Warren St.
Trenton, NJ 08618-4741
Grant Number
H80CS00531
Participating Start Date
12/1/1992
Last Recertification Date
2/19/2025
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
Contacts
Covered Entity Signing Official
Kemi Alli, Chief Executive Officer
(609) 278-5909
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/16/2023
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