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WALMART PHARMACY 10-5282
RRC330226-00 THE UNITY HOSPITAL OF ROCHESTER
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Covered Entity Details
Entity Name
THE UNITY HOSPITAL OF ROCHESTER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC330226-00
Entity Address
1555 LONG POND ROAD
ROCHESTER, NY 14626
Medicare Provider Number
330226
Participating Start Date
9/1/2021
Last Recertification Date
Entity Termination Date
3/15/2022
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5282
Pharmacy Address
3800 DEWEY AVE
GREECE, NY 14616
Pharmacy Comments
Contract Details
Approval Date
9/2/2021
Contract Begin Date
9/2/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/15/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Hugh Thomas, Executive Vice President, Chief Administrative Officer
(585) 922-4941
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
9/2/2021
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