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WAL-MART PHARMACY 10-5997
CH045220 RURAL HEALTH SERVICES INC
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Covered Entity Details
Entity Name
RURAL HEALTH SERVICES INC
Subdivision Name
MARGARET J. WESTON HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH045220
Entity Address
4645 AUGUSTA ROAD
Beech Island, SC 29842
Grant Number
H80CS00653
Participating Start Date
7/1/1996
Last Recertification Date
2/24/2025
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
10/9/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carolyn Emanuel-McClain, CEO
(803) 380-7012
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
10/9/2017
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