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WAL-MART PHARMACY 10-1171
CH04431AT MCR Health, Inc.
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Covered Entity Details
Entity Name
MCR Health, Inc.
Subdivision Name
South County Medical Center
Type
HRSA-Funded Health Center
340B ID
CH04431AT
Entity Address
579 A South Indiana Avenue
Englewood, FL 34223
Grant Number
H80CS00097
Participating Start Date
4/1/2016
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1171
Pharmacy Address
8320 LOCKWOOD RIDGE
SARASOTA, FL 34243
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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