340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-3632
RRC230216-00 MCLAREN PORT HURON
Print
Covered Entity Details
Entity Name
MCLAREN PORT HURON
Subdivision Name
Type
Rural Referral Center
340B ID
RRC230216-00
Entity Address
1221 PINE GROVE AVENUE
PORT HURON, MI 48060
Medicare Provider Number
230216
Participating Start Date
12/7/2021
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3632
Pharmacy Address
655 WEST SANILAC ROAD
SANDUSKY, MI 48471
Pharmacy Comments
Contract Details
Approval Date
1/17/2022
Contract Begin Date
2/4/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/9/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Bridget Ann Sholtis, CFO
(810) 989-3749
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/17/2022
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