340B Drug Pricing Program Database
WALMART PHARMACY 10-5169
DSH050261 Sierra View Medical Center - information as of 5/12/2025 12:29:03 AM
Covered Entity Details
Entity Name
Sierra View Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050261
Entity Address
465 W PUTNAM AVENUE
PORTERVILLE, CA 93257
Medicare Provider Number
050261
Participating Start Date
7/1/2004
Last Recertification Date
8/16/2024
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
4/21/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ron Wheaton, Vice President of Professional Services/Physician Recruitment
(559) 788-6106
Contract Pharmacy Representative
Walmart
Nick Tallman, Sr. Director, Merchandise Operations – Pharmacy
(479) 371-0417
Signed By Date
4/21/2025
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