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WAL-MART CENTRAL FILL 10-2670
CAH521351-00 REEDSBURG AREA MEDICAL CENTER
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Covered Entity Details
Entity Name
REEDSBURG AREA MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH521351-00
Entity Address
2000 N DEWEY AVE
REEDSBURG, WI 53959
Medicare Provider Number
521351
Participating Start Date
1/1/2011
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
WAL-MART CENTRAL FILL 10-2670
Pharmacy Address
608 SPRING HILL DR # 3 SUITE 300
SPRING, TX 77386
Pharmacy Comments
Contract Details
Approval Date
4/8/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ROBERT VANMEETEREN, CEO/PRESIDENT
(608) 524-6487
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/8/2021
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