340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-2794
CAH461303-00 IHC Health Services INC dba INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL
Print
Covered Entity Details
Entity Name
IHC Health Services INC dba INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH461303-00
Entity Address
1100 SOUTH MEDICAL DRIVE
MT. PLEASANT, UT 84647
Medicare Provider Number
461303
Participating Start Date
10/1/2014
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2794
Pharmacy Address
777 NO. MAIN STREET
EPHRAIM, UT 84627
Pharmacy Comments
Contract Details
Approval Date
1/14/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/27/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Aaron Wood, CEO/Administrator-Sanpete
(435) 462-4123
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/14/2019
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