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WAL-MART PHARMACY 10-5997
CH058470 COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
Subdivision Name
CNHC dba PrimaryOne Health
Type
HRSA-Funded Health Center
340B ID
CH058470
Entity Address
2780 Airport Drive, Suite 100
Columbus, OH 43219-1060
Grant Number
H80CS00118
Participating Start Date
10/1/1998
Last Recertification Date
2/19/2025
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
1/12/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Charleta B. Tavares, CEO
(614) 859-1946
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/12/2017
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