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WALMART PHARMACY 10-5169
DSH340070 ALAMANCE REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
ALAMANCE REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340070
Entity Address
1240 HUFFMAN MILL ROAD
BURLINGTON, NC 27215
Medicare Provider Number
340070
Participating Start Date
7/1/2015
Last Recertification Date
8/29/2023
Entity Termination Date
4/1/2024
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-5169
Pharmacy Address
2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756
Pharmacy Comments
Contract Details
Approval Date
1/6/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Andrew Barrow, Chief Financial Officer
(336) 832-7825
Contract Pharmacy Representative
Walmart
Julie Howard, 340b Program Manager
(479) 739-1973 Ext: 4792771498
Signed By Date
1/6/2023
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