340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALMART PHARMACY 10-7168
DSH460009 University of Utah
Print
Covered Entity Details
Entity Name
University of Utah
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH460009
Entity Address
50 North Medical Drive
Salt Lake City, UT 84132
Medicare Provider Number
460009
Participating Start Date
7/1/1996
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-7168
Pharmacy Address
5056 W 13400 S.
HERRIMAN, UT 84096
Pharmacy Comments
Contract Details
Approval Date
7/14/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Charlton Gordon Park, Chief Financial Officer
(801) 585-1325
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
7/14/2022
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