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WALMART PHARMACY 10-5169
STD333341 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Dixie Hwy
Type
Sexually Transmitted Diseases
340B ID
STD333341
Entity Address
5333 N. Dixie Hwy
Suite 110
Fort Lauderdale, FL 33334
Grant Number
1 NH25PS005131-01-00
Participating Start Date
1/1/2018
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
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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