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WAL-MART PHARMACY 10-5997
FQHCLA270 CASTLE FAMILY HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
CASTLE FAMILY HEALTH CENTERS, INC.
Subdivision Name
CASTLE FAMILY HEALTH CENTERS AT CASTLE
Type
Health Center Program Look-Alike
340B ID
FQHCLA270
Entity Address
3605 HOSPITAL ROAD
ATWATER, CA 95301-5173
Grant Number
LALCS00012
Participating Start Date
10/1/2010
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5997
Pharmacy Address
9600 PARKSOUTH CT. SUITE 100
ORLANDO, FL 32837
Pharmacy Comments
Contract Details
Approval Date
7/25/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Edward Lujano, CEO
(209) 381-2000 Ext: 7001
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/25/2017
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