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WAL-MART PHARMACY 10-0908
STD33334 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Oakland Park
Type
Sexually Transmitted Diseases
340B ID
STD33334
Entity Address
1421 E Oakland Park Blvd
Suite 200
Fort Lauderdale, FL 33334
Grant Number
1 NH25PS005131-01-00
Participating Start Date
7/1/2017
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0908
Pharmacy Address
8101 SO. JOHN YOUNG PKWY.
ORLANDO, FL 32819
Pharmacy Comments
Contract Details
Approval Date
1/21/2024
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
1/21/2024
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