340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0409
DSH010125 LAKELAND COMMUNITY HOSPITAL
Print
Covered Entity Details
Entity Name
LAKELAND COMMUNITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH010125
Entity Address
42024 HIGHWAY 195 EAST
HALEYVILLE, AL 35565
Medicare Provider Number
010125
Participating Start Date
4/1/2020
Last Recertification Date
8/16/2021
Entity Termination Date
4/1/2022
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0409
Pharmacy Address
42466 HIGHWAY 195 EAST
HALEYVILLE, AL 35565
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
4/29/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Ashley Pool, Chief Executive Officer
(205) 485-7108
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/15/2020
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