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WALMART PHARMACY 10-5169
CAH201305-00 Calais Community Hospital
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Covered Entity Details
Entity Name
Calais Community Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH201305-00
Entity Address
24 HOSPITAL LANE
CALAIS, ME 04619
Medicare Provider Number
201305
Participating Start Date
9/28/2010
Last Recertification Date
9/4/2024
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
Lynnette Parr, CFO
(207) 255-0269
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/4/2023
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