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WALMART PHARMACY 10-2443
CAH431305-00 DOUGLAS COUNTY MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
DOUGLAS COUNTY MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH431305-00
Entity Address
708 8TH ST
ARMOUR, SD 57313
Medicare Provider Number
431305
Participating Start Date
7/1/2011
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-2443
Pharmacy Address
7821 S. MINNESOTA AVENUE
SIOUX FALLS, SD 57108-7271
Pharmacy Comments
Contract Details
Approval Date
10/14/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
HEATH BROUWER, CEO
(605) 724-2159
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
10/14/2022
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