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WALMART PHARMACY 10-5393
DSH340091 THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION
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Covered Entity Details
Entity Name
THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340091
Entity Address
1200 NORTH ELM STREET
GREENSBORO, NC 27401-1020
Medicare Provider Number
340091
Participating Start Date
4/1/2006
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5393
Pharmacy Address
1050 ALAMANCE CHURCH ROAD
GREENSBORO, NC 27406
Pharmacy Comments
Contract Details
Approval Date
7/14/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeffrey Jones, Executive VP and CFO
(336) 832-8005
Contract Pharmacy Representative
Walmart
Julie Howard, 340b Program Manager
(479) 739-1973 Ext: 4792771498
Signed By Date
7/14/2020
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