340B Drug Pricing Program Database
WAL-MART 10-5441
CAH171354-00 COMMUNITY HEALTHCARE SYSTEM, INC. - information as of 4/25/2025 9:41:17 PM
Covered Entity Details
Entity Name
COMMUNITY HEALTHCARE SYSTEM, INC.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH171354-00
Entity Address
120 W 8TH STREET
ONAGA, KS 66521
Medicare Provider Number
171354
Participating Start Date
9/16/2010
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
WAL-MART 10-5441
Pharmacy Address
2600 NW ROCHESTER RD
TOPEKA, KS 66617
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/17/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
MONICA HOLTHAUS, CFO
(785) 889-5036
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/12/2018
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