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WAL-MART PHARMACY 10-3370
CH04431BK MCR Health, Inc.
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Covered Entity Details
Entity Name
MCR Health, Inc.
Subdivision Name
MCR Health Southeast High School
Type
HRSA-Funded Health Center
340B ID
CH04431BK
Entity Address
1200 37th Ave E
Bradenton, FL 34208-4553
Grant Number
H80CS00097
Participating Start Date
4/1/2020
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3370
Pharmacy Address
508 10TH ST. E.
PALMETTO, FL 34221
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
MONICA RIDER, Chief Medical Officer
(941) 999-0310
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
7/15/2024
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