340B Drug Pricing Program Database


WAL-MART PHARMACY 10-0253 - information as of 5/14/2025 12:11:58 AM


WAL-MART PHARMACY 10-0253

1316 SOUTH STATE STREET
JERSEYVILLE, IL 62052



  • Contracts
  • History
Contracts
Contract Detail340B IDEntity NameSub NameEntity TypeAddressAddress Cont.CityStateBegin DateTerm DateEdit Date
DetailsCAH141300-00THOMAS H BOYD CRITICAL ACC HOSPITAL Critical Access Hospital800 SCHOOL STREET
CARROLLTONIL07/01/2019 7/1/2019 12:05 AM
DetailsCH053320SIHF HealthcareSIHF HealthcareHRSA-Funded Health Center2041 Goose Lake Rd,
SaugetIL10/01/2019 10/1/2019 12:05 AM
DetailsDSH140052OSF SAINT ANTHONY'S HEALTH CENTER Disproportionate Share Hospital1 SAINT ANTHONYS WAY
ALTONIL10/01/201609/08/20181/3/2019 11:11 AM
DetailsDSH260091SSM HEALTH ST MARY'S HOSPITAL-STL Disproportionate Share Hospital6420 CLAYTON ROAD
ST. LOUISMO07/01/201804/12/20194/12/2019 11:06 AM
DetailsDSH260091SSM HEALTH ST MARY'S HOSPITAL-STL Disproportionate Share Hospital6420 CLAYTON ROAD
ST. LOUISMO04/17/2019 4/25/2019 11:32 AM
DetailsDSH260104SSM HEALTH DEPAUL HOSPITAL Disproportionate Share Hospital12303 DePaul Dr
BRIDGETONMO07/01/2018 4/13/2018 6:04 PM
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
AddressesPharmacy AddressInsert  WAL-MART PHARMACY 10-0253 1316 SOUTH STATE STREET JERSEYVILLE, IL 620529/29/2017 6:44 AM
DetailsCommentsInsert   3/28/2013 4:21 PM
DetailsIs DeletedInsert  False3/28/2013 4:21 PM
AddressesPharmacy AddressInsert  WAL-MART PHARMACY 10-0253 1316 SOUTH STATE STREET JERSEYVILLE, IL 620523/28/2013 4:21 PM
DetailsNameInsert  WAL-MART PHARMACY 10-02533/28/2013 4:21 PM