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WALMART PHARMACY 10-5169
DSH390041 UNIONTOWN HOSPITAL
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Covered Entity Details
Entity Name
UNIONTOWN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390041
Entity Address
500 WEST BERKELEY STREET
UNIONTOWN, PA 15401
Medicare Provider Number
390041
Participating Start Date
4/1/2005
Last Recertification Date
8/22/2024
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
1/17/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Barbara Ann Weiss, Executive Director, Finance/CFO
(724) 430-5222
Contract Pharmacy Representative
Uniontown Hospital
Barbara Ann Weiss, Executive Director, Finance/CFO
(724) 430-5222
Signed By Date
1/17/2023
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