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WAL-MART PHARMACY 10-4570
CH02371AG INSTITUTE FOR FAMILY HEALTH, THE
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Covered Entity Details
Entity Name
INSTITUTE FOR FAMILY HEALTH, THE
Subdivision Name
Family Health Center of Harlem
Type
HRSA-Funded Health Center
340B ID
CH02371AG
Entity Address
1824 Madison Ave
New York, NY 10035-3832
Grant Number
H80CS00768
Participating Start Date
10/1/2010
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-4570
Pharmacy Address
7500 ROUTE 209
NAPANOCH, NY 12458
Pharmacy Comments
Contract Details
Approval Date
5/15/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nicole Nurse, Sr Vice President for Clinical Affairs
(212) 633-0800 Ext: 1241
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
5/15/2017
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