340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0165
RRC450102-00 CHRISTUS MOTHER FRANCES HOSP-TYLER
Print
Covered Entity Details
Entity Name
CHRISTUS MOTHER FRANCES HOSP-TYLER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC450102-00
Entity Address
800 EAST DAWSON ST.
TYLER, TX 75701
Medicare Provider Number
450102
Participating Start Date
8/13/2020
Last Recertification Date
8/20/2021
Entity Termination Date
3/10/2022
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0165
Pharmacy Address
2121 HWY. 79 SOUTH
HENDERSON, TX 75654
Pharmacy Comments
Contract Details
Approval Date
1/13/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/10/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Elizabeth Pulliam, Chief Financial Officer
(903) 606-4102
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/13/2022
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