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WAL-MART PHARMACY 10-5997
DSH340008 SCOTLAND MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
SCOTLAND MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340008
Entity Address
500 LAUCHWOOD DRIVE
LAURINBURG, NC 28352
Medicare Provider Number
340008
Participating Start Date
7/1/2004
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5997
Pharmacy Address
9600 PARKSOUTH CT. SUITE 100
ORLANDO, FL 32837
Pharmacy Comments
Contract Details
Approval Date
4/13/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David L Pope, Senior Vice President, Operations
(910) 291-7502
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/13/2020
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