340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0071
SCH040047-00 FIVE RIVERS MEDICAL CENTER
Print
Covered Entity Details
Entity Name
FIVE RIVERS MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH040047-00
Entity Address
2801 MEDICAL CENTER DRIVE
POCAHONTAS, AR 72455
Medicare Provider Number
040047
Participating Start Date
4/1/2021
Last Recertification Date
8/29/2022
Entity Termination Date
10/1/2023
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0071
Pharmacy Address
1415 HWY 67 SOUTH
POCAHONTAS, AR 72455
Pharmacy Comments
Contract Details
Approval Date
5/24/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Matt Taylor Nichols, CFO
(870) 892-6204
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
5/24/2021
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