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WALMART PHARMACY 10-5169
CAH151317-00 GREENE COUNTY GENERAL HOSPITAL
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Covered Entity Details
Entity Name
GREENE COUNTY GENERAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH151317-00
Entity Address
1185 N 1000 W
LINTON, IN 47441-9457
Medicare Provider Number
151317
Participating Start Date
1/1/2015
Last Recertification Date
8/26/2024
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
1/16/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
April Settles, CFO
(812) 847-5212
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/16/2023
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