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WAL-MART PHARMACY 10-0151
SCH370034-00 MCALESTER REGIONAL HEALTH CENTER
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Covered Entity Details
Entity Name
MCALESTER REGIONAL HEALTH CENTER
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH370034-00
Entity Address
1 CLARK BASS BOULEVARD
MCALESTER, OK 74501
Medicare Provider Number
370034
Participating Start Date
7/1/2021
Last Recertification Date
9/12/2023
Entity Termination Date
7/1/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0151
Pharmacy Address
432 S GEORGE NIGH EXPWY
MCALESTER, OK 74501
Pharmacy Comments
Contract Details
Approval Date
7/16/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
David N. Keith, President/CEO
(918) 421-8010
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
7/16/2021
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