340B Drug Pricing Program Database
WALMART PHARMACY 10-5169
CAH371323-00 WEATHERFORD HOSPITAL AUTHORITY - information as of 5/2/2025 11:00:01 PM
Covered Entity Details
Entity Name
WEATHERFORD HOSPITAL AUTHORITY
Subdivision Name
WEATHERFORD REGIONAL HOSPITAL
Type
Critical Access Hospital
340B ID
CAH371323-00
Entity Address
3701 E MAIN STREET
WEATHERFORD, OK 73096
Medicare Provider Number
371323
Participating Start Date
5/9/2018
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
Pharmacy Comments
Contract Details
Approval Date
4/15/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Darin Farrell, President
(580) 774-4750
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
4/15/2025
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