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WAL-MART PHARMACY WHSE #45
STD3280612 Sunshine Specialty Health Outreach Foundation
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Covered Entity Details
Entity Name
Sunshine Specialty Health Outreach Foundation
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD3280612
Entity Address
220 E. Gore St
Orlando, FL 32806
Grant Number
5nu62ps924532-02
Participating Start Date
10/12/2022
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY WHSE #45
Pharmacy Address
2250 NORTH 8TH STREET
SUITE 102-A
ROGERS, AR 72756
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jillian Hall, CEO
(407) 888-5980
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
7/15/2024
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