Contract Pharmacy Details

WALMART PHARMACY #10-6190
CH040370 FLORIDA CHC'S, INC.

Covered Entity Details

Entity Name

FLORIDA CHC'S, INC.

Subdivision Name

Type

HRSA-Funded Health Center

340B ID

CH040370

Entity Address

5827 CORPORATE WAY
WEST PALM BEACH, FL 33407

Grant Number

H80CS00798

Participating Start Date

12/1/1992

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

WALMART PHARMACY #10-6190

Pharmacy Address

1951 W HICKPOCHEE AVE
LABELLE, FL 33935

Pharmacy Comments

Contract Details

Approval Date

7/6/2016

Contract Begin Date

10/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/16/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

KATHY AMATO, VICE PRESIDENT & CFO
(561) 844-9443 Ext: 311

Contract Pharmacy Representative

Walmart
Julie Howard, 340B Program Manager
(479) 277-1498

Signed By Date

7/6/2016

340B Drug Pricing Program Database