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WALMART PHARMACY 10-5169
CAH181319-00 BRECKINRIDGE HEALTH, INC.
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Covered Entity Details
Entity Name
BRECKINRIDGE HEALTH, INC.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH181319-00
Entity Address
1011 OLD HIGHWAY 60
HARDINSBURG, KY 40143
Medicare Provider Number
181319
Participating Start Date
7/1/2011
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
1/17/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Amy Arndell, Chief Financial Officer
(270) 756-6655
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
1/17/2023
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