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WALMART PHARMACY 10-5169
CAH281361-00 LEXINGTON REGIONAL HEALTH CENTER
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Covered Entity Details
Entity Name
LEXINGTON REGIONAL HEALTH CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH281361-00
Entity Address
1201 N. ERIE STREET
LEXINGTON, NE 68850-0980
Medicare Provider Number
281361
Participating Start Date
9/2/2010
Last Recertification Date
9/3/2024
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
4/7/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
WADE ESCHENBRENNER, CFO
(308) 324-8302
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
4/7/2023
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