340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-2587
DSH040007 ST VINCENT INFIRMARY
Print
Covered Entity Details
Entity Name
ST VINCENT INFIRMARY
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH040007
Entity Address
#2 ST. VINCENT CIRCLE
ATTN: PHARMACY
LITTLE ROCK, AR 72205
Medicare Provider Number
040007
Participating Start Date
7/1/2003
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2587
Pharmacy Address
304 SOUTH ROCKWOOD
CABOT, AR 72023
Pharmacy Comments
Contract Details
Approval Date
4/22/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/20/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Chad Aduddell, COO
(501) 552-3906
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
4/22/2013
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