340B Drug Pricing Program Database
WAL-MART PHARMACY 10-5997
CAH231311-00 Deckerville Community Hospital. Inc. - information as of 6/2/2025 9:15:05 AM
Covered Entity Details
Entity Name
Deckerville Community Hospital. Inc.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH231311-00
Entity Address
3559 Pine St
Deckerville, MI 48427
Medicare Provider Number
231311
Participating Start Date
1/1/2014
Last Recertification Date
8/19/2024
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
4/12/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kim Gentner, Director of Finance
(810) 376-7024
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
4/12/2021
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