Pharmacy Details

WAL-MART PHARMACY 10-0786 - information as of 5/5/2025 10:54:57 PM

Name
WAL-MART PHARMACY 10-0786

Address

2300 SYCAMORE ROAD
DEKALB, IL 60115

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	DSH140239	Javon Bea Hospital		Disproportionate Share Hospital	8201 E Riverside Blvd		Rockford	IL	04/01/2020	08/24/2022	9/13/2022 2:43 PM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Pharmacy Address	Insert			WAL-MART PHARMACY 10-0786 2300 SYCAMORE ROAD DEKALB, IL 60115	9/29/2017 6:44 AM
Details	Comments	Insert				3/28/2013 4:20 PM
Details	Is Deleted	Insert			False	3/28/2013 4:20 PM
Addresses	Pharmacy Address	Insert			WAL-MART PHARMACY 10-0786 2300 SYCAMORE ROAD DEKALB, IL 60115	3/28/2013 4:20 PM
Details	Name	Insert			WAL-MART PHARMACY 10-0786	3/28/2013 4:20 PM