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WAL-MART PHARMACY 10-0811
CH04431U MCR Health, Inc.
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Covered Entity Details
Entity Name
MCR Health, Inc.
Subdivision Name
MYAKKA CITY FAMILY MEDICAL CTR
Type
HRSA-Funded Health Center
340B ID
CH04431U
Entity Address
37220 GLENWOOD AVE
MYAKKA CITY, FL 34251-4251
Grant Number
H80CS00097
Participating Start Date
4/1/2013
Last Recertification Date
2/20/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0811
Pharmacy Address
2725 SOUTHEAST HWY 70
ARCADIA, FL 34266
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/15/2025
Business decision by covered entity and/or pharmacy
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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