340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0711
DSH180017 TJ SAMSON COMMUNITY HOSPITAL
Print
Covered Entity Details
Entity Name
TJ SAMSON COMMUNITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180017
Entity Address
1301 NORTH RACE STREET
GLASGOW, KY 42141
Medicare Provider Number
180017
Participating Start Date
7/1/2005
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0711
Pharmacy Address
2345 HAPPY VALLEY RD.
GLASGOW, KY 42141
Pharmacy Comments
Contract Details
Approval Date
4/13/2012
Contract Begin Date
4/13/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
BILL KINDRED, CEO
(270) 651-4159
Contract Pharmacy Representative
Wal--Mart
Marcus Osborne, Sales & Contracting
(479) 204-8452
Signed By Date
4/6/2012
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