340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-3206
RRC360009-00 LIMA MEMORIAL HOSPITAL
Print
Covered Entity Details
Entity Name
LIMA MEMORIAL HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC360009-00
Entity Address
1001 BELLEFONTAINE AVENUE
LIMA, OH 45804
Medicare Provider Number
360009
Participating Start Date
5/4/2020
Last Recertification Date
8/24/2023
Entity Termination Date
10/1/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3206
Pharmacy Address
2400 HARDING HIGHWAY
LIMA, OH 45804
Pharmacy Comments
Contract Details
Approval Date
10/23/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Eric Donald Pohjala, CFO
(419) 226-5163
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
10/23/2020
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