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WAL-MART PHARMACY 10-3344
SCH490005-00 WINCHESTER MEDICAL CENTER
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Covered Entity Details
Entity Name
WINCHESTER MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH490005-00
Entity Address
1840 AMHERST STREET
WINCHESTER, VA 22601
Medicare Provider Number
490005
Participating Start Date
1/22/2021
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3344
Pharmacy Address
501 WAL-MART DRIVE
WINCHESTER(W), VA 22603
Pharmacy Comments
Contract Details
Approval Date
7/14/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Peter F. Gallagher, CFO
(540) 536-8031
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/14/2021
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