340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0586
CH047060 LITTLE RIVER MEDICAL CENTER, INC.
Print
Covered Entity Details
Entity Name
LITTLE RIVER MEDICAL CENTER, INC.
Subdivision Name
LITTLE RIVER MEDICAL CENTER, INC.: MAIN SITE
Type
HRSA-Funded Health Center
340B ID
CH047060
Entity Address
4303 Live Oak Dr.
Little River, SC 29566
Grant Number
H80CS00700
Participating Start Date
12/1/1992
Last Recertification Date
2/16/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0586
Pharmacy Address
2709-A CHURCH STREET
CONWAY, SC 29526
Pharmacy Comments
Contract Details
Approval Date
2/8/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kristopher Chiplinski, Director of Pharmacy
(843) 663-8031
Contract Pharmacy Representative
Marcus Osborne, VP of Health & Wellness Sales and Contracting
(479) 204-9374
Signed By Date
1/4/2013
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