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WAL-MART PHARMACY 10-1462
SCH010150-00 Regional Medical Center of Central Alabama
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Covered Entity Details
Entity Name
Regional Medical Center of Central Alabama
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH010150-00
Entity Address
29 LV STABLER DRIVE
GREENVILLE, AL 36037
Medicare Provider Number
010150
Participating Start Date
10/1/2019
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1462
Pharmacy Address
501 WILLOW LN
GREENVILLE, AL 36037
Pharmacy Comments
Contract Details
Approval Date
10/14/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Glenn Wilcox, Chief Financial Officer
(334) 383-2423
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/14/2019
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