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WALMART PHARMACY 10-5169
CAH191306-00 WEST FELICIANA PARISH HOSPITAL
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Covered Entity Details
Entity Name
WEST FELICIANA PARISH HOSPITAL
Subdivision Name
A POLITICAL SUBDIVISION OF THE PARISH OF WEST FELICIANA PARISH
Type
Critical Access Hospital
340B ID
CAH191306-00
Entity Address
5266 COMMERCE STREET
SAINT FRANCISVILLE, LA 70775
Medicare Provider Number
191306
Participating Start Date
10/1/2018
Last Recertification Date
8/23/2024
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
4/3/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ledoux Chastant, CEO
(225) 635-2441
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/3/2023
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