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WALMART PHARMACY 10-5169
DSH190140 FRANKLIN MEDICAL CENTER
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Covered Entity Details
Entity Name
FRANKLIN MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190140
Entity Address
2106 LOOP ROAD
WINNSBORO, LA 71295
Medicare Provider Number
190140
Participating Start Date
1/1/2011
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
4/4/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MICHAEL BLAKE KRAMER, CEO
(318) 412-5265
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/4/2023
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