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WAL-MART PHARMACY 10-5997
CH040370 FLORIDA CHC'S, INC.
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Covered Entity Details
Entity Name
FLORIDA CHC'S, INC.
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH040370
Entity Address
5827 CORPORATE WAY
WEST PALM BEACH, FL 33407
Grant Number
H80CS00798
Participating Start Date
12/1/1992
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5997
Pharmacy Address
9600 PARKSOUTH CT. SUITE 100
ORLANDO, FL 32837
Pharmacy Comments
Contract Details
Approval Date
7/21/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KATHY AMATO, VICE PRESIDENT & CFO
(561) 844-9443 Ext: 311
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
7/21/2017
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