340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-2140
CAH301310-00 ANDROSCOGGIN VALLEY HOSPITAL , Inc.
Print
Covered Entity Details
Entity Name
ANDROSCOGGIN VALLEY HOSPITAL , Inc.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH301310-00
Entity Address
59 PAGE HILL ROAD
BERLIN, NH 03570-3542
Medicare Provider Number
301310
Participating Start Date
9/29/2010
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2140
Pharmacy Address
46 NORTH SOUTH RD
NORTH CONWAY, NH 03860
Pharmacy Comments
Contract Details
Approval Date
7/1/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/13/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Suzanne Landry, Vice President
(603) 326-5608
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/1/2021
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