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WALMART PHARMACY 10-5169
STD322075 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Jacksonville
Type
Sexually Transmitted Diseases
340B ID
STD322075
Entity Address
4615 Philips Highway
Suite 3
Jacksonville, FL 32207
Grant Number
1 NH25PS005131-01-00
Participating Start Date
7/1/2016
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
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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