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WAL-MART PHARMACY 10-5758
CHC26626-00 FOUNDCARE INC.
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Covered Entity Details
Entity Name
FOUNDCARE INC.
Subdivision Name
FoundCare Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26626-00
Entity Address
2330 S. Congress Avenue
West Palm Beach, FL 33406-7608
Grant Number
H80CS26626
Participating Start Date
4/1/2014
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5758
Pharmacy Address
3911 JOG RD
GREENACRES, FL 33467
Pharmacy Comments
Contract Details
Approval Date
1/14/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/29/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Rik Pavlescak, Chief Administrative Officer
(561) 432-7902
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
1/14/2014
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