Pharmacy Details

WAL-MART PHARMACY 10-3511 - information as of 5/13/2025 11:32:02 PM

Name
WAL-MART PHARMACY 10-3511

Address

550 W. HONEYSUCKLE AVE.
HAYDEN, ID 83835

Comments

Contracts
History

Contracts

Contract Detail	340B ID	Entity Name	Sub Name	Entity Type	Address	Address Cont.	City	State	Begin Date	Term Date	Edit Date
Details	CH108170	Dirne Health Centers, Inc.	Heritage Health CDA	HRSA-Funded Health Center	1090 W Park Pl		Coeur D Alene	ID	04/01/2014		1/14/2014 1:13 PM
Details	CH10817J	DIRNE HEALTH CENTERS, INC.	Dirne CHC Physical Therapy	HRSA-Funded Health Center	610 W Hubbard St		Coeur D Alene	ID	01/01/2015	01/01/2016	2/12/2015 2:16 PM
Details	DSH130049	KOOTENAI HEALTH INC	KOOTENAI HEALTH	Disproportionate Share Hospital	2003 Kootenai Health Way		COEUR DALENE	ID	10/01/2014	04/01/2019	4/1/2019 12:05 AM
Details	DSH130049	KOOTENAI HEALTH INC	KOOTENAI HEALTH	Disproportionate Share Hospital	2003 Kootenai Health Way		COEUR DALENE	ID	07/01/2021	07/01/2025	4/28/2025 2:42 PM
Details	RRC130049-00	KOOTENAI HEALTH INC		Rural Referral Center	2003 KOOTENAI HEALTH WAY		COEUR DALENE	ID	04/01/2019	07/01/2021	7/1/2021 12:01 AM
Details	RRC130049-00	KOOTENAI HEALTH INC		Rural Referral Center	2003 KOOTENAI HEALTH WAY		COEUR DALENE	ID	07/01/2025		4/28/2025 2:42 PM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Pharmacy Address	Insert			WAL-MART PHARMACY 10-3511 550 W. HONEYSUCKLE AVE. HAYDEN, ID 83835	9/29/2017 6:44 AM
Details	Comments	Update				3/28/2013 4:29 PM
Addresses	Pharmacy Address	Update		WAL-MART PHARMACY 10-3511 550 W. Honeysuckle Ave. Hayden, ID 83835	WAL-MART PHARMACY 10-3511 550 W. HONEYSUCKLE AVE. HAYDEN, ID 83835	3/28/2013 4:29 PM
Addresses	Pharmacy Address	Update		Wal-Mart Pharmacy 3511 550 W. Honeysuckle Ave. Hayden, ID 83835	WAL-MART PHARMACY 10-3511 550 W. Honeysuckle Ave. Hayden, ID 83835	3/8/2013 10:59 AM
Details	Name	Update		Wal-Mart Pharmacy 3511	WAL-MART PHARMACY 10-3511	3/8/2013 10:59 AM
Details	Comments	Insert				1/11/2013 7:59 AM
Details	Is Deleted	Insert			False	1/11/2013 7:59 AM
Addresses	Pharmacy Address	Insert			Wal-Mart Pharmacy 3511 550 W. Honeysuckle Ave. Hayden, ID 83835	1/11/2013 7:59 AM
Details	Name	Insert			Wal-Mart Pharmacy 3511	1/11/2013 7:59 AM