340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-4554
DSH450124 Dell Seton Medical Center at The University of Texas
Print
Covered Entity Details
Entity Name
Dell Seton Medical Center at The University of Texas
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450124
Entity Address
1500 RED RIVER ST
AUSTIN, TX 78701
Medicare Provider Number
450124
Participating Start Date
3/11/2021
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-4554
Pharmacy Address
2525 W ANDERSON LN.
AUSTIN, TX 78757
Pharmacy Comments
Contract Details
Approval Date
7/3/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Christann M Vasquez, President
(512) 324-7074
Contract Pharmacy Representative
Wal-mart
Laura Levine, Manager Contracting
(479) 204-8550
Signed By Date
7/3/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session