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WAL-MART PHARMACY 10-5315
STD292016 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Columbia
Type
Sexually Transmitted Diseases
340B ID
STD292016
Entity Address
1911 Hampton St
Columbia, SC 29201
Grant Number
NU62PS924531
Participating Start Date
7/1/2020
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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