340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
STD32114 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Daytona
Type
Sexually Transmitted Diseases
340B ID
STD32114
Entity Address
1125 N. Nova Rd.
Daytona Beach, FL 32117
Grant Number
NU62PS924532
Participating Start Date
1/1/2016
Last Recertification Date
5/28/2025
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
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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