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WAL-MART PHARMACY 10-5997
CHC24172-00 CHRIST COMMUNITY HEALTH SERVICES AUGUSTA, INC.
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Covered Entity Details
Entity Name
CHRIST COMMUNITY HEALTH SERVICES AUGUSTA, INC.
Subdivision Name
Christ Community Health: Medical District CHC
Type
HRSA-Funded Health Center
340B ID
CHC24172-00
Entity Address
1226 Dantignac St
Augusta, GA 30901-2788
Grant Number
H80CS24172
Participating Start Date
7/1/2013
Last Recertification Date
2/20/2025
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
7/23/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas J. Drake III, Executive Director
(706) 922-3017
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/23/2017
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