Pharmacy Details

WAL-MART PHARMACY 10-4230 - information as of 4/27/2025 11:43:26 PM

Name
WAL-MART PHARMACY 10-4230

Address

10105 LIMA ROAD
FORT WAYNE, IN 46818

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	CAH151310-00	Parkview Wabash Hospital, Inc		Critical Access Hospital	10 John Kissinger Drive		WABASH	IN	01/01/2016	02/10/2017	2/10/2017 10:43 AM
Details	DSH150021	Parkview Hospital		Disproportionate Share Hospital	11109 PARKVIEW PLAZA DRIVE		FORT WAYNE	IN	01/01/2016	02/10/2017	2/10/2017 11:19 AM
Details	DSH150021	Parkview Hospital		Disproportionate Share Hospital	11109 PARKVIEW PLAZA DRIVE		FORT WAYNE	IN	10/01/2019	12/27/2023	12/27/2023 12:01 AM
Details	DSH150101	WHITLEY MEMORIAL HOSPITAL		Disproportionate Share Hospital	1260 E STATE ROAD 205		COLUMBIA CITY	IN	01/01/2016	02/10/2017	5/11/2017 1:26 PM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Pharmacy Address	Insert			WAL-MART PHARMACY 10-4230 10105 LIMA ROAD FORT WAYNE, IN 46818	9/29/2017 6:44 AM
Details	Comments	Update				3/28/2013 4:17 PM
Addresses	Pharmacy Address	Update		Wal-Mart 10105 LIMA RD FORT WAYNE, IN 46818	WAL-MART PHARMACY 10-4230 10105 LIMA ROAD FORT WAYNE, IN 46818	3/28/2013 4:17 PM
Details	Name	Update		Wal-Mart	WAL-MART PHARMACY 10-4230	3/28/2013 4:17 PM
Details	Comments	Insert				8/12/2012 9:59 AM
Details	Is Deleted	Insert			False	8/12/2012 9:59 AM
Addresses	Pharmacy Address	Insert			Wal-Mart 10105 LIMA RD FORT WAYNE, IN 46818	8/12/2012 9:59 AM
Details	Name	Insert			Wal-Mart	8/12/2012 9:59 AM