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WAL-MART PHARMACY 10-1996
STD33168 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
North Miami
Type
Sexually Transmitted Diseases
340B ID
STD33168
Entity Address
18360 NW 47th Ave
Miami Gardens, FL 33055
Grant Number
1 NH25PS005131-01-00
Participating Start Date
7/1/2016
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1996
Pharmacy Address
2551 E. HALLANDALE BCH. BLVD.
HALLANDALE, FL 33009
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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