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WAL-MART PHARMACY 10-2262
CAH331320-00 Bassett Hospital of Schoharie County dba Cobleskill Regional Hospital
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Covered Entity Details
Entity Name
Bassett Hospital of Schoharie County dba Cobleskill Regional Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH331320-00
Entity Address
178 Grandview Drive
Cobleskill, NY 12043
Medicare Provider Number
331320
Participating Start Date
10/1/2019
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2262
Pharmacy Address
5054 STATE HWY 23
ONEONTA, NY 13820
Pharmacy Comments
Contract Details
Approval Date
7/13/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher Manley, Director of Pharmacy
(518) 254-3278
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
7/13/2020
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