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WALMART PHARMACY 10-5169
CAH431305-00 DOUGLAS COUNTY MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
DOUGLAS COUNTY MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH431305-00
Entity Address
708 8TH ST
ARMOUR, SD 57313
Medicare Provider Number
431305
Participating Start Date
7/1/2011
Last Recertification Date
8/15/2024
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
4/10/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
HEATH BROUWER, CEO
(605) 724-2159
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
4/10/2023
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