340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-1620
DSH010099 D W MCMILLAN MEMORIAL HOSPITAL
Print
Covered Entity Details
Entity Name
D W MCMILLAN MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH010099
Entity Address
1301 BELLEVILLE AVENUE
BREWTON, AL 36427
Medicare Provider Number
010099
Participating Start Date
11/15/2022
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1620
Pharmacy Address
2578 DOUGLAS AVENUE
BREWTON, AL 36426
Pharmacy Comments
Contract Details
Approval Date
11/16/2022
Contract Begin Date
11/16/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stacy Hines, Administrator
(251) 809-8429
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
11/16/2022
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