Contract Pharmacy Details

WAL-MART PHARMACY 10-3370
CH04431AJ MCR Health, Inc.

Covered Entity Details

Entity Name

MCR Health, Inc.

Subdivision Name

Mobile Eye Care

Type

HRSA-Funded Health Center

340B ID

CH04431AJ

Entity Address

12271 Us Highway 301 N
Parrish, FL 34219-8410

Grant Number

H80CS00097

Participating Start Date

1/1/2016

Last Recertification Date

2/12/2025

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

340B Drug Pricing Program Database