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WAL-MART PHARMACY 10-5315
STD235102 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Fort Tar
Type
Sexually Transmitted Diseases
340B ID
STD235102
Entity Address
1001 Monticello Ave
Suite 100
Norfolk, VA 23510
Grant Number
NH25PS005137
Participating Start Date
4/1/2022
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5315
Pharmacy Address
2354 COMMERCE PARK DR.
ORLANDO, FL 32819
Pharmacy Comments
Contract Details
Approval Date
10/27/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rishi Patel, President & CEO
(941) 300-4440 Ext: 11127
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/27/2023
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