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WAL-MART PHARMACY 10-3387
CHC31892-00 Centerplace Health, Inc.
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Covered Entity Details
Entity Name
Centerplace Health, Inc.
Subdivision Name
Sally and Sam Shapiro Babies and Children&s Medical Center
Type
HRSA-Funded Health Center
340B ID
CHC31892-00
Entity Address
1750 17th St. BLDG E
Sarasota, FL 34234-8632
Grant Number
H80CS31892
Participating Start Date
10/1/2018
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3387
Pharmacy Address
17000 TAMIAMI TRAIL
NORTH PORT, FL 34287
Pharmacy Comments
Contract Details
Approval Date
11/26/2024
Contract Begin Date
12/3/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Anna Ferguson, Interim CEO
(941) 529-0200
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
11/26/2024
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