340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-5315
SCH250095-00 South Sunflower County Hospital
Print
Covered Entity Details
Entity Name
South Sunflower County Hospital
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH250095-00
Entity Address
121 East Baker Street
Indianola, MS 38751-2462
Medicare Provider Number
250095
Participating Start Date
10/1/2013
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5315
Pharmacy Address
2354 COMMERCE PARK DR.
ORLANDO, FL 32819
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
Courtney Phillips, Administrator/CFO
(662) 635-7200
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/14/2020
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