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WAL-MART PHARMACY 10-4690
STD342372 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Sarasota
Type
Sexually Transmitted Diseases
340B ID
STD342372
Entity Address
1231 N. Tuttle Ave
Sarasota, FL 34237
Grant Number
1 NH25PS005131-01-00
Participating Start Date
1/1/2016
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-4690
Pharmacy Address
201 - 34TH STREET N
SAINT PETERSBURG, FL 33713
Pharmacy Comments
Contract Details
Approval Date
1/18/2024
Contract Begin Date
4/1/2024
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, 340B Program Manager
(479) 277-1498
Signed By Date
1/18/2024
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