340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-2739
DSH010129 GULF HEALTH HOSPITALS, INC. DBA NORTH BALDWIN INFIRMARY
Print
Covered Entity Details
Entity Name
GULF HEALTH HOSPITALS, INC. DBA NORTH BALDWIN INFIRMARY
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH010129
Entity Address
1815 HAND AVE.
BAY MINETTE, AL 36507
Medicare Provider Number
010129
Participating Start Date
7/1/2005
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2739
Pharmacy Address
701 MCMEANS AVENUE
BAY MINETTE, AL 36507
Pharmacy Comments
Contract Details
Approval Date
4/19/2012
Contract Begin Date
4/19/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Ormand Thompson, Administrator
(251) 580-1717
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
4/5/2012
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