340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0969
DSH250123 SINGING RIVER GULFPORT
Print
Covered Entity Details
Entity Name
SINGING RIVER GULFPORT
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH250123
Entity Address
15200 COMMUNITY ROAD
GULFPORT, MS 39503-5307
Medicare Provider Number
250123
Participating Start Date
3/11/2022
Last Recertification Date
8/28/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0969
Pharmacy Address
9350-A HIGHWAY 49 NORTH
GULFPORT, MS 39503
Pharmacy Comments
Contract Details
Approval Date
4/5/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Heath Allen Thompson, Administrator Ancillary Services
(228) 818-1191
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/5/2022
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