Pharmacy Details

WAL-MART PHARMACY 10-5090 - information as of 5/20/2025 2:02:23 AM

Name
WAL-MART PHARMACY 10-5090

Address

1415 LAWRENCE DR
DE PERE, WI 54115

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	CAH521346-00	ThedaCare Medical Center Shawano, Inc.		Critical Access Hospital	100 County Road B		Shawano	WI	04/01/2022	05/30/2023	5/31/2023 10:12 AM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Pharmacy Address	Insert			WAL-MART PHARMACY 10-5090 1415 LAWRENCE DR DE PERE, WI 54115	9/29/2017 6:44 AM
Details	Comments	Insert				3/28/2013 4:19 PM
Details	Is Deleted	Insert			False	3/28/2013 4:19 PM
Addresses	Pharmacy Address	Insert			WAL-MART PHARMACY 10-5090 1415 LAWRENCE DR DE PERE, WI 54115	3/28/2013 4:19 PM
Details	Name	Insert			WAL-MART PHARMACY 10-5090	3/28/2013 4:19 PM